Real-Time Optimal Flow Setting and Respiratory Profile Evaluation in Infants Treated with High-Flow Nasal Cannula (HFNC)

Abstract

High-flow nasal cannula (HFNC) is becoming the gold standard to treat respiratory distress at any age since it potentially provides several significant clinical advantages. An obstacle to the diffusion of this simple and effective system of oxygen therapy is the impossibility to know the optimal flow rate leading to such advantages that allows the reduction in the respiratory effort without causing hyperinflation. To assist clinicians during HFNC treatment in setting the optimal flow rate and in determining the most relevant parameters related to respiratory mechanics and the effort of the patient, we developed a new programmable data monitoring, acquisition, and elaborating system (Pro_HFNC). The application of Pro_HFNC is fully compatible with HFNC as it is interfaced with patient through a facial mask and two specific catheters. The unavoidable and unpredictable loss of air flow occurring around the contour of the mask is evaluated and compensated by a specific algorithm implemented by Pro_HFNC. Our preliminary clinical trials on pediatric patients treated with HFNC show that Pro_HFNC is actually capable to detect for any specific patient both the lower threshold of the delivered flow beyond which the benefits of HFNC application are reached and all the parameters useful for a complete evaluation of the respiratory profile. Pro_HFNC can really help physicians in setting the optimal flow rate during HFNC treatment, thus allowing for the most effective HFNC performance.