The Seven Types of Patients That Could Benefit from High Velocity Therapy

High Velocity Therapy delivered with high velocity therapy is mask-free noninvasive ventilation (NIV) for spontaneously breathing patients. It is a viable alternative to NiPPV and can relieve undifferentiated respiratory distress, including hypercapnia and hypoxemia.^[1] It is one user-friendly tool that could benefit a variety of patients from neonate to end-of-life.

1. Premature Babies

Vapotherm’s^® high velocity therapy is a safe and efficacious^[2] mask-free alternative to CPAP^[3,4] for neonates. During the vulnerable first days, when it is critical for babies to focus on growing, high velocity therapy is a gentle approach for primary^[3] and post-extubation^[4] support. The open system and mask-free interface reduces the risk of skin breakdown and facilitates kangaroo care, letting families bond and allowing babies to be babies first.

2. Pediatric Patients

One of the most common forms of respiratory distress in pediatric patients is caused by bronchiolitis. Children’s skin is generally more fragile and so they benefit from the easy-to-tolerate gentleness of a mask-free interface. In addition to that, the optimally conditioned medical grade vapor^[5] created by high velocity therapy can help relieve symptoms associated with bronchiolitis by promoting mucociliary clearance.^[6]

3. Flu Patients

Pneumonia is one of the serious complications of the flu. As with all congested patients, one of the keys to recovery is ensuring secretion clearance. High velocity therapy provides optimally conditioned gas that promotes secretion clearance.^[7] The image to the right comes from Gaylord Hospital in Wallingford, CT. The patient was placed on high velocity therapy on the day of admission. The staff employed standard clinical care and did not employ any additional mechanisms for secretion mobilization. The X-ray taken five days later demonstrates the effectiveness of high velocity therapy in secretion mobilization.

4. Bearded Patients and Others Whose Facial Proportions May Prevent Mask Seals

Clinicians treating respiratory distress patients may be familiar with the frustration of wasting critical time speed-shaving a patient to ensure an NiPPV mask will have a proper seal. The advantage of a mask-free system for this type of patient is easy to recognize. A recent randomized, controlled, multi-center trial has shown that High Velocity Therapy has the same clinical efficacy as NiPPV^[1] in treating undifferentiated respiratory distress in adults, but due to the mask-free interface, high velocity therapy eliminates the need for a mask seal. The mask-free interface not only enhances patient comfort but offers clinicians a user-friendly tool at the front-lines of respiratory care. When asked about simplicity of use, clinicians^[1] rated high velocity therapy more highly than NiPPV.

5. Patients Presenting in Undifferentiated Respiratory Distress in the Emergency Department

High velocity therapy is a simple front-line tool for treating patients presenting in the Emergency Department in undifferentiated respiratory distress, including hypercapnia and hypoxemia.^[1] Clinicians not used to high velocity therapy may express surprise at the idea of an open system being able to relieve hypercapnia, but as Figure 1 illustrates, there is no significant difference between high velocity therapy and NiPPV when it comes to the reduction of CO₂ in adult patients. This allows emergency department clinicians to have one comfortable go-to tool when admitting patients in respiratory distress.

6. Patients with Mask-Intolerance and Mask Anxiety

Patients with mask-intolerance present a familiar problem to clinicians prescribing NiPPV to relieve respiratory distress. Studies show that more than 30% of NIV failure is attributed to patients who are mask-intolerant.^[8] Techniques for reducing anxiety such as coaching, or sitting with patients, may increase intensity of care. Additionally, patients failing NiPPV and having to be intubated results in both increased risks and costs. High velocity therapy offers a viable, mask-free alternative to NiPPV, particularly for the mask-intolerant patient.

Figure 2 illustrates just such a case of an NiPPV intolerant patient placed on Hi-VNI Technology. You can read the full case study here.

7. End-of-Life Palliative Care Patients

Comfort is a priority when it comes to palliative care patients. Rather than spending their last days and hours with their face behind a mask, end-of-life patients and their families prefer to be able to talk to their loved one and see them smile. With high velocity therapy, palliative care patients can receive the gentle and effective respiratory support they need while still being able to talk, eat, drink, and take oral medication. The mask-free patient interface reduces the risk of skin breakdown and enhances comfort as compared to mask therapies.

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