High-Flow Oxygen for Comfort Care–Only Patients with Respiratory Insufficiency

In a small randomized crossover study, oxygen by high-flow nasal cannula improved patient-reported dyspnea substantially more than conventional oxygen therapy.

End-of-life palliative care patients suffering respiratory distress are challenging to treat. Most cases have a declared “do not intubate” status, and noninvasive positive pressure ventilation is uncomfortable or intolerable for many.

To determine the utility of oxygen by high-flow nasal cannula (HFNC), researchers in Thailand randomized adult palliative care patients who presented to an emergency department with respiratory failure to receive HFNC or conventional oxygen therapy (regular nasal cannula or nonrebreather mask). Each patient was assigned to one therapy for 60 minutes, then crossed over to the alternate therapy. Saturation goals were 95%. HFNC delivery was started at 35 L/minute and titrated up to 60 L/minute as needed. The prima…

Reviewing Author

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

High-Flow Oxygen for Comfort Care–Only Patients with Respiratory Insufficiency

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Reviewing Author