Adult High-Flow Nasal Cannula Weaning and Disassembly Strategies
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Abstract
Introduction: The high-flow nasal cannula is a system that uses a humidified and heated air-oxygen mixture with a flow rate of up to 70 liters per minute. It is mostly used in acute respiratory failure of hypoxemic origin, where it has been shown to provide greater comfort and resolving power of hypoxemia, compared to conventional oxygen therapy. Although its indications and follow-up strategy are known, in clinical practice the weaning/weaning process is not clear.
Objective: To identify in the bibliography the existing literature on weaning/ weaning strategies of high-flow nasal cannula in adults.
Methods: A bibliographic review was carried out in the databases of the regional portal of the BVS, PubMed, Web Of Science, Scopus and Google scholar, without time limit and structuring a PIO equation with keywords and Boléan connectors. Articles published in English and Spanish, full text, were assumed.
Results: The literature still reports discrepancy in the process of weaning and disassembling the high-flow nasal cannula, but most of the studies found in this review propose to decrease the Fio2 first gradually (5-10%) to values of 30-50% and then the flow. To dismantle it, one could consider having a Fio2 between 30-50%, flow between 20-30 liters per minute, Sao2 >92%, with adequate respiratory mechanics and state of consciousness.
Conclusion: There is still no unanimity on the weaning/weaning process in the high-flow nasal cannula in the adult patient.
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References
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