High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility

  • Anshul Mittal Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
  • Megha Varshney Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
  • Vidushi Rathi Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
  • Pranav Ish | pranavish2512@gmail.com Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Abstract

High flow nasal cannula (HFNC) provides warmed and humidified air with flow rates up to 60 liters/min with relatively fixed oxygen content (FiO2). It has been extensively evaluated for hypoxemic respiratory failure and has been used in mild acute respiratory distress syndrome, pre-intubation, bronchoscopy and pediatric obstructive sleep apnea. Recent data has suggested a role in stable hypercapnic chronic obstructive pulmonary disease (COPD) and even in acute exacerbations, though, the use has not been advocated by any guidelines yet. We present a case of acute hypercapnic exacerbation of COPD, intolerant to non-invasive ventilation, showing response and improvement on use of HFNC. This case highlights this potential mechanisms and prospects for the same.

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Published
2020-01-21
Info
Issue
Section
Pneumology - Case Reports
Keywords:
High flow, exacerbation, hypercapnia
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How to Cite
Mittal, A., Varshney, M., Rathi, V., & Ish, P. (2020). High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility. Monaldi Archives for Chest Disease, 90(1). https://doi.org/10.4081/monaldi.2020.1158