High flow nasal cannula: Mechanism of action, indications, benefits, and potential risks

Fathony Arsyad 1 and Muhammad Zulfadli Syahrul 2, *

1 Residency Program in Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Andalas, Indonesia.
2 Department of Anesthesiology and Intensive Therapy, M Djamil Central General Hospital/Faculty of Medicine, Universitas Andalas, Indonesia.
 
Review Article
World Journal of Advanced Research and Reviews, 2024, 24(03), 2020-2026
Article DOI: 10.30574/wjarr.2024.24.3.3863
 
Publication history: 
Received on 05 November 2024; revised on 17 December 2024; accepted on 19 December 2024
 
Abstract: 
High Flow Nasal Cannula (HFNC) is a non-invasive oxygen therapy device with high flow that is increasingly used to treat patients with acute respiratory failure, especially in hypoxemic cases. HFNC offers several advantages, such as optimal humidification, reduced breathing work, and increased oxygenation, reducing the need for invasive mechanical ventilation. This paper aims to elucidate the mechanism of action, indications, clinical monitoring, benefits, and potential risks of HFNC use in adult patients with various clinical conditions. HFNC has various beneficial physiological effects, including increasing oxygenation by reducing anatomical dead space and producing end-expiratory positive pressure (PEEP). The main indications for HFNC include acute hypoxemic respiratory failure, post-extubation, and patients with “do not intubate” (DNI) status. In addition to its benefits, HFNC has risks, such as delayed intubation, hypercapnia, and gastric inflation, requiring close monitoring. HFNC is an effective and easily tolerated modality for treating mild to moderate acute respiratory failure. However, more research is needed to determine optimal use criteria and guidelines for therapy escalation.
 
Keywords: 
Acute respiratory failure; High flow nasal cannula (HFNC); Hypoxemic Oxygenation; Non-Invasive Oxygen Therapy
 
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