High-flow oxygen therapy: Non-invasive respiratory support

High-flow oxygen therapy (HFOT) is non-invasive respiratory support that delivers warmed, humidified, oxygen-enriched air to patients. High-flow oxygen therapy can provide respiratory support for patients with acute respiratory failure and can also prevent subsequent intubation. The beneficial effects of HFOT may be explained by its good tolerance and by physiological characteristics including delivery of high inspiratory oxygen concentration (FiO2), positive end expiratory pressure (PEEP) effect and continuous dead space washout contributing to decreased work of breathing. It leads to improvements in oxygenation, respiratory rate, dyspnea and patient comfort and helps patients recover faster following extubation. This type of o2 therapy is also economical, as it does not necessarily require a ventilator, and can be used across different hospital departments. It has been found that high-flow oxygen therapy can reduce mortality of patients with ARF admitted to intensive care unit as compared to non-invasive ventilation (NIV). HFOT might therefore be considered as a first-line strategy of oxygenation in these patients. In contrast, NIV should be used cautiously in patients with ARF due to high tidal volumes promoted by pressure support and that may potentially worsen pre-existing lung injury. In this review article it will be discuss about high-flow oxygen therapy and/or non-invasive ventilation used only as a therapeutic measure for the treatment of acute respiratory failure, while prophylactic applications designed to prevent the onset of acute respiratory failure will not be discussed.