High-Flow Nasal Cannula Reduces Effort of Breathing But Not Consistently via Positive End-Expiratory Pressure
R.D. Guglielmo, Justin Hotz, Patrick A. Ross, Timothy Deakers, Jennifer Diep, Christopher J. L. Newth, Robinder G. Khemani
Abstract
BACKGROUND: High-flow nasal cannula (HFNC) therapy reduces the effort of breathing in patients with bronchiolitis, but the mechanisms are not understood. Theorized mechanisms include dead space washout and positive end-expiratory pressure (PEEP) application. RESEARCH QUESTION: What are the mechanisms of action of HFNC therapy in patients with bronchiolitis? STUDY DESIGN AND METHODS: would not change and that effort would reduce via respiratory rate (not ΔPes). Measurements were reported as the difference from 0.5 L/kg/min. RESULTS: O/min from 0.5 L/kg/min to 2 L/kg/min (P = .02), with all patients demonstrating a reduction in PRP, with a nonsignificant change in ΔPes (P = .68). INTERPRETATION: or transpulmonary pressure. This suggests that PEEP application is not the primary mechanism of action of HFNC in children with bronchiolitis.