TY - JOUR AU - Frat, Jean-Pierre AU - Coudroy, Rémi AU - Marjanovic, Nicolas AU - Thille, Arnaud W. PY - 2017 TI - High-flow nasal oxygen therapy and noninvasive ventilation in the management of acute hypoxemic respiratory failure JF - Annals of Translational Medicine; Vol 5, No 14 (July 25, 2017): Annals of Translational Medicine (Focus on “Acute Respiratory Distress Syndrome”) Y2 - 2017 KW - N2 - High-flow nasal cannula (HFNC) oxygen therapy is a recent technique delivering a high flow of heated and humidified gas. HFNC is simpler to use and apply than noninvasive ventilation (NIV) and appears to be a good alternative treatment for hypoxemic acute respiratory failure (ARF). HFNC is better tolerated than NIV, delivers high fraction of inspired oxygen (FiO 2 ), generates a low level of positive pressure and provides washout of dead space in the upper airways, thereby improving mechanical pulmonary properties and unloading inspiratory muscles during ARF. A recent multicenter randomized controlled trial showed benefits of HFNC concerning mortality and intubation in severe patients with hypoxemic ARF. In management of patients with hypoxemic ARF, NIV results have been conflicting. Despite improved oxygenation, NIV delivered with face mask may generate high tidal volumes and subsequent ventilator-induced lung injury. An approach applying NIV with a helmet, high levels of positive end-expiratory pressure (PEEP) and low pressure support (PS) levels seems to open new opportunities in patients with hypoxemic ARF. However, a large-scale randomized controlled study is needed to assess and compare this approach with HFNC. UR - https://atm.amegroups.org/article/view/15608