High flow oxygen therapy in intensive care and anaesthesiology

Following the review of the current literature, the principles and practical effects of the application of high-flow oxygen therapy (HFO2T) among intensive care patients and those subjected to surgical procedures were presented.

The results of HFO2T usage go beyond achieving stable and controlled oxygen concentration in the inspiratory air. Additional effects are associated with obtaining positive pressure during exhalation, CO2 wash-out and functional reduction of dead space, end-expiratory lung volume increase as a result of micro atelectasis reduction and improved distribution of tidal volume. As a result of optimal humidification and heating of the inspiratory mixture, resistance of breathing and work of breathing are reduced. The described HFO2T effects encourage attempts to use it not only as a passive oxygen therapy tool, but also as an alternative device for noninvasive ventilation or early intubation. The range of applications evaluated in the literature includes acute hypoxemic respiratory failure, initial phase of ARDS,

COPD, perioperative period and applications during diagnostic processes (gastroscopy, bronchoscopy). A special form of HFO2T, currently undergoing evaluation, is the adaptation of the method for patients with tracheostomy, which mainly improves the processes of moisturizing the breathing mixture. HFO2T requires further evaluation in large, randomised trials, however, the effects of use to date are encouraging.