Five Reasons Your Hospital Should Try High Velocity Nasal Insufflation

High Velocity Nasal Insufflation (HVNI) is Mask-Free Noninvasive Ventilation pioneered by Vapotherm® for the treatment of undifferentiated respiratory distress in spontaneously breathing patients. Here are a few benefits that hospitals, clinicians, and their patients may experience with this breakthrough at the frontlines of respiratory care.

1. Clinical Efficacy of NiPPV, but Without the Mask

Figure 1: Adapted from Doshi et al, HVNI in the Treatment of Respiratory Failure, Ann of Emerg Med, 2017; 1:11.

In a multi-center, randomized, controlled trial published in 2018 in the Annals of Emergency Medicine, Doshi and colleagues conclude that HVNI is a viable alternative to non-invasive positive pressure ventilation (NiPPV).[1] The trial enrolled adults presenting in the Emergency Department in undifferentiated respiratory distress, and showed statistically equivalent outcomes in avoiding intubations, (Figure 1). This study was conducted on Vapotherm’s Hi-VNI® Technology, which as of the time of this writing has the only mask-free system cleared by the Food and Drug Administration (FDA) for the treatment of undifferentiated respiratory distress in spontaneously breathing patients.

2. Caring for Patients who Can’t or Won’t Wear a Mask

Patients with mask-intolerance due to anxiety, nausea or facial hair 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.[2] 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. Hi-VNI Technology 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.

Figure 2: Case Study from Athens Regional Medical Center (GA) of NiPPV intolerant patient successfully stabilized with Hi-VNI Technology.
Although individual results may vary, Vapotherm believes this case study is an example of the clinical benefit Vapotherm’s Hi-VNI Technology can have in an Emergency Department setting.

3. Greater Patient Comfort via a Simple Mask-Free Interface

HVNI delivered with Hi-VNI Technology is a gentle, easy to tolerate respiratory treatment that allows patients to eat, drink, and take oral medications while receiving respiratory support. The mask-free interface enables easy communication with clinicians and family members, all of which may lead to greater compliance with the treatment. The lack of a tight-fitting mask may also lead to fewer hospital acquired pressure injuries.

4. Ability to Transfer and Ambulate Patients Without Compromising Respiratory Support

The Vapotherm Transfer Unit (VTU) allows for in-hospital transfers as well as user-friendly patient ambulation while the patient still received full respiratory support.

In the ED the ability to move patients on therapy can greatly improve workflow. For one hospital’s success story using Hi-VNI Technology with the VTU to streamline workflow streamlining thanks to read about Norman Regional Hospital — one of the five busiest Emergency Departments in Oklahoma.

5. A User-Friendly De-Escalation Therapy

You want to know fast if a respiratory support modality will work for a particular patient. The faster you stabilize the better. With Hi-VNI Technology you can safely start patients at high flow rates to rescue fast, and then titrate down for comfort and clinical effect. Unlike the tightly strapped on mask of NiPPV, the non-occlusive Hi-VNI cannula creates an open system interface with the patient, and as a result, there is little risk of generating inadvertent excess pressure. Instead of starting low and turning therapy up for effect, you can safely start high and turn down on response.

Figure 3 illustrates the degree to which clinicians in Doshi and colleagues’ study[1] rated Hi-VNI Technology patient response compared to NiPPV.

Doshi et al, HVNI in the Treatment of Respiratory Failure, Ann of Emerg Med, 2017; 1:11.

Learn more about Hi-VNI Technology

[1] Doshi, Pratik et al. High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Annals of Emergency Medicine, 2018.
[2] Carron M. et al. Complications of non-invasive ventilation techniques: a comprehensive qualitative review of randomized trials. British Journal of Anaesthesia. 110(6):896-914. (2013)