High Flow Nasal Cannula Use in Patients Outside of the Intensive Care Unit Pathway Background and Objectives High flow systems are designed to heat and humidify gas mixtures for safe delivery at flow rates that meet or exceed a patient’s inspiratory flow demands, thereby decreasing work of breathing in the setting of respiratory illness. In addition to the benefits of avoiding more invasive modes of ventilatory support, HFNC therapy has the potential to decrease metabolic demands and facilitate safe enteral nutrition earlier in the disease course. The objectives of this pathway are to: Define the criteria for initiating HFNC on patients who may be appropriately managed outside of the ICU Outline the management for titration and weaning of respiratory support Review the feeding and monitoring guidelines for this group of patients Identify the circumstances under which a Medical Emergency Team (MET) should be activated Algorithm Download HFNC Outside of ICU Pathway Algorithm – Updated March 16, 2023 Quality Metrics Duration of HFNC support Percentage of patients with MET activations Percentage of patients requiring transfer to the ICU Hospital length of stay Educational Module Download HFNC Outside of ICU Educational Module – Updated March 16, 2023 Key References Venanzi A, Di Filippo P, Santagata C, Di Pillo S, Chiarelli F, Attanasi M. Heated Humidified High-Flow Nasal Cannula in Children: State of the Art. 2022 Sep 21;10(10):2353.CID: PMC9598483. Nolasco S, Manti S, Leonardi S, Vancheri C, Spicuzza L. High-Flow Nasal Cannula Oxygen Therapy: Physiological Mechanisms and Clinical Applications in Children. Front Med (Lausanne). 2022 Jun 3;9:920549. Pathway Contacts Kathy Kalkbrenner, MD Kara Denz Fluck, PAC Lisa LeBon, RRT Justin Rearick, RRT Disclaimer The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case. View all Clinical Pathways >
