Summary: High-Flow Oxygen Therapy: Pressure Analysis in a Pediatric Airway Model

Topic: Pressure – Pediatrics

By Urbano, H; Castillo, J; Lopez-Herce, J; Gallardo, J; Solana, M; Carillo, A. . Resp Care 2012: 57(5), 721-726.

Urbano and colleagues used a pediatric manikin bench model to evaluate HFT against high flow nasal mask or oronasal interface; this manikin model is a much better portrayal if actual airway geometry compared to other bench studies on HFT. Pressures were measured in the airway as well as the device circuit while delivering flows up to 20 L/min. The data confirm that the nasal cannula does not generate significant, or in this case measureable, airway pressured when applied without holding the mouth closed to block up oral pathway for gas flow. However, compared to the mask applications, circuit pressure is increased 30 to 100 fold when the same high flows are administered through the cannula. Thus, although a HFT device must be able to tolerate the high pressures associated with nasal cannula delivery, HFT does not create a marked CPAP effect. In this regard, the authors concluded that the effects seen with HFT must be related to other mechanisms.

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