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P166 Initiative to improve outcomes through the use of an adult protocol for high-flow nasal cannula

T. Dempsey
Author and Funding Information

Internal Medicine, University of California-Davis, Sacramento, United States


Copyright 2017, American College of Chest Physicians and Swiss Respiratory Society SGP. All Rights Reserved.


Chest. 2017;151(5_S):A64. doi:10.1016/j.chest.2017.04.068
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Extract

Introduction: High Flow Nasal Cannula (HFNC) is an oxygen delivery modality that has been increasing in popularity over the past few years as trials have shown it to be a non-inferior option in patients with acute hypoxic respiratory failure. At UC Davis, a recent retrospective study for failure rates (defined as need for transfer to the ICU, initiation of non-invasive ventilation or endotracheal intubation) in floor patients placed on HFNC was undertaken and demonstrated that 25/66 patients analyzed (38%) failed HNFC therapy. The mortality of patients who failed HFNC was also higher (48%) than the non-failure group (39%). It is unclear why this occurred, but there seems to be a lack of knowledge regarding when HFNC should be initiated and who should be involved in the decision to utilize it. Thus, the decision was made to create a protocol for the initiation and use of HFNC in floor patients and to study its effect on failure rates.

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