Pankaj Nigam
Country Manager,
Shenyang RMS Medical Tech Co. Ltd.

Future Trend Technology HFNC

“The effectiveness of HFO therapy using HFNC (AIRT-B1/B2) may lead to improved oxygenation in patients combined with fewer desaturations, improved lung volumes, improved respiratory rates, reduced ICU length of stay, and reduced treatment cost.”

On market trends

Based on clinical evidence, high-flow therapy is useful in patients that are spontaneously breathing but have an increased work of breathing. Conditions such as general respiratory failure, asthma exacerbation, COPD exacerbation, bronchiolitis, pneumonia, and congestive heart failure are all possible situations where high-flow therapy may be indicated. HHHF has been used in spontaneously breathing patients with during general anesthesia to facilitate sugary for airway obstruction, such as mechanical ventilation.

Optiflow was designed with Fisher & Paykel’s (F&P) concept of optimal humidity in mind, which allows high flow oxygen and gas to be delivered comfortably directly into the nostrils. Optimal humidity reflects what F&P calls the natural balance of temperature and humidity that occurs in healthy adult lungs. This optimal temperature (37°C/98.6°F) and humidity (44 mg/L) improve patient tolerance and optimize mucociliary clearance, according to Fisher & Paykel.

The system integrates heated humidification and precision air/oxygen blend via high flow nasal cannula. While humidification improves patient tolerance and airway secretion clearance, the high gas flow drives accurate delivery of oxygen, washout of anatomical deadspace, and provision of low level positive airway pressure.

According to Shenyang RMS Medical Tech Co. Ltd., the effectiveness of HFO therapy using HFNC (AIRT-B1/B2) may lead to improved oxygenation in patients combined with fewer desaturations, improved lung volumes, improved respiratory rates, reduced ICU length of stay, and reduced treatment cost.

On technology trends

HFO consists of a heated, humidified high flow nasal cannula (HFNC) that can deliver up to 100 percent heated and humidified oxygen at a maximum flow of 80 LPM via nasal prongs or cannula. An air/oxygen blender can provide precise oxygen delivery independent of the patient’s inspiratory flow demands.

On buyer’s perspective

The consumables like heated circuits and nasal cannula are designed for single patient use or maximum 15 days of hospitalization. As the cost of consumables like heating tube, humidifier and high flow nasal cannula is very high. Earlier it was proprietary, now these are available in comparatively better price with unmatched quality for consumables and equipment.

On clinical application

High flow oxygen delivery has been clinically utilized in a wide spectrum of patient care arenas. It has been administered to patient populations in critical care units, emergency departments, and end-of-life scenarios, and recently has migrated into the home care environment. In the adult critical care population, there have been several studies that have demonstrated positive outcomes, post-HFO utilization.

In a 2013 study of high flow oxygen via HFNC devices for adult and perinatal patients, Ward concluded that HFO had the following therapeutic effects:

  • Increased fraction of inspired oxygen (FiO2)
  • Gas inlet flow prevents secondary room-air entrainment;
  • Provides anatomic oxygen reservoirs using nasopharynx and oropharynx;
  • Washing out of airway dead space;Development of a CPAP effect
  • Decreases atelectasis;
  • Improvement in pulmonary ventilation-perfusion;
  • Decreases work of breathing: counteracts intrinsic PEEP;
  • Greater patient comfort
  • Warmed and humidified nasal oxygen can be better tolerated, especially with flows >6 LPM. Compared HFNC with conventional oxygen therapy via a mask in 20 critical care patients and demonstrated that HFNC was better tolerated and more comfortable than an oxygen mask. HFNC also was associated with an improvement in oxygenation and a reduction in respiratory rate.
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