What question did this study set out to answer?

This study aims to describe characteristics and outcomes of patients using high-flow nasal cannula in the emergency department's resuscitation room.

March 7, 2026Open Access

High flow nasal cannula in the emergency department’s resuscitation room: a prospective monocenter descriptive study

Key Points

This study aims to describe characteristics and outcomes of patients using high-flow nasal cannula in the emergency department's resuscitation room.
Prospective cohort study
Monocenter analysis
Included adults with acute respiratory failure requiring ≥ 9 L/min oxygen
Recorded demographic data, clinical parameters, and hospital trajectories
Classified patients based on HFNC initiation
35% of patients received HFNC; 65% did not
HFNC patients were younger and had lower comorbidities
84% of HFNC patients diagnosed with infectious pneumonia vs. 53% non-HFNC
68% of HFNC patients admitted to ICU vs. 37% non-HFNC
In-hospital mortality was 21% for HFNC vs. 33% for non-HFNC

Abstract

High-flow nasal cannula (HFNC) therapy is commonly used in emergency departments (EDs) to treat acute respiratory failure (ARF). However, its utilization patterns in the resuscitation room (RR) are not well documented. The aim of this study was to describe patient characteristics, management, and in-hospital trajectories according to HFNC use. We conducted a prospective, monocenter, cohort study of consecutive adults admitted to the RR with ARF requiring ≥ 9 L/min of oxygen. We recorded demographic data, comorbidities, clinical and biological parameters, imaging results, treatments, and final ED diagnoses. Patients were classified according to HFNC initiation in the RR. We described clinical pathways through a structured flow diagram that included ICU admission, escalation of respiratory support and in-hospital mortality. Among 165 patients, 57 (35%) received HFNC and 108 (65%) did not. Patients receiving HFNC were younger (73 59; 86 vs. 77 70;87 years old) and had a lower Charlson index (5 3; 7 vs. 7 5; 9). Median NEWS2 score at admission was 8 6; 9 in both groups. Infectious pneumonia was the primary ED diagnosis in 84% of HFNC patients (48/57) and 53% of non-HFNC patients (57/108). Cardiogenic pulmonary oedema accounted for 5% (3/57) vs. 21% (23/108), respectively. ICU admission occurred in 39 (68%) of HFNC patients and 40 (37%) of non-HFNC patients. Intubation was performed in 3 (5.3%) vs. 10 (9.3%). In-hospital mortality was 12/57 (21%) in the HFNC group and 35/108 (33%) in the non-HFNC group. Patients who receive HFNC therapy in the RR are younger and healthier than those who do not, regardless of the initial severity of acute respiratory failure ARF. The probability of receiving HFNC seems to be linked to the patient’s burden of comorbidities. Further study should explore its impact on patient outcomes. None.

Bookmark

View Full Paper