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Surgical Innovation
July 11, 2018

High-Flow Nasal Cannula SystemNot Just Another Nasal Cannula

Author Affiliations
  • 1Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 2Surgical Critical Care, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
JAMA Surg. Published online July 11, 2018. doi:10.1001/jamasurg.2018.1984

Interest has been on the increase in noninvasive respiratory support modalities to harness the advantages of positive pressure ventilation while avoiding the complications associated with invasive modalities. High-flow nasal cannula (HFNC) offers an alternative to other oxygenation therapies, including standard noninvasive positive pressure ventilation (NIPPV), and has been studied in diverse clinical settings. The HFNC system includes a flow meter, an air-oxygen blender, a humidifier, a heated circuit, and large-bore nasal prongs that interact directly with the patient (Figure).1 Multiple HFNC devices are commercially available and allow the clinician to set an oxygen (O2) flow rate of up to 60 L/min and a fraction of inspired oxygen (Fio2) reaching 100%.2

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