Thread by @dastrainees

#JanuAIRWAY Day 9. High Flow Nasal Oxygen (HFNO). This has been a game-changer in recent years. Thank you A.Patel and S Nouraei for their amazing landmark paper on THRIVE! 🔗pubmed.ncbi.nlm.nih.gov/25388828/
Let’s dive in…
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Oxygen consumption continues during apnoea, gradual loss of alveolar volume/reduction in pressure. If upper airway remains patent, gas can be drawn into lower airways and oxygenation can continue and delay desaturation.
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HFNO:
1. Reduces heat and moisture loss from the airway
2. Decreases anatomical deadspace
3. Provides PEEP
4. Improves Oxygenation

See this @BJAJournals article which summarises the physiological basis and clinical contraindications👇
🔗academic.oup.com/bjaed/article/…
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HFNO Limitations:
1) Airway must be patent
2) Secretions can accumulate
3) Obesity – shorter duration of oxygenation, more rapid desaturation.
4) CO2 accumulation (apnoeic patients) – without hypoxia / raised ICP, unlikely to be problem
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Here are some papers / links you might find interesting:
🔗academic.oup.com/bjaed/article/…
🔗pubmed.ncbi.nlm.nih.gov/25388828/
🔗bjanaesthesia.org/article/S0007-…
🔗…-publications.onlinelibrary.wiley.com/doi/full/10.11…
🔗epmonthly.com/article/no-des…
If you have any others, tweet them to us for inclusion next time!
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Hope that helps. Tomorrow we'll look at the Cook Airway Exchange Catheter. See you then!
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*Disclaimer: Inclusion of content (equipment, techniques and scoring systems etc.) in #JanuAIRWAY does not constitute DAS endorsement