Saturday, July 23, 2016

ED High-Flow nasal O2 for ARD

The Bottom Line - By Duncan Chambler - 5th July 2016 - Peer-review editor: Steve Mathieu 
Ref. Jones. Respiratory Care 2016; 61(3):291-299. doi:10.4187/respcare.04252 
"Clinical Question 
In hypoxic adults presenting to the emergency department, does nasal high-flow oxygen compared to standard oxygen therapy reduce the need for advanced respiratory support? 
Authors’ Conclusions 
Oxygen therapy delivered by high-flow nasal cannulae did not reduce the need for non-invasive or invasive ventilation when compared against standard oxygen therapy 
However, the trial was unexpectedly underpowered and a true, clinically important benefit may exist, therefore this trial should be considered a pilot for a larger (~900 patient) trial 
One in 12 patients are intolerant of oxygen delivery via high-flow nasal cannulae 
The Bottom Line 
This trial did not demonstrate a difference between nasal high-flow oxygen and standard oxygen therapy in hypoxic and dyspneic patients arriving in the Emergency Department 
Significant weaknesses in the methodology mean that no firm conclusion can be drawn, as a false positive result may have occurred"