[en] BACKGROUND: Despite the extensive use of high-flow nasal cannula (HFNC) therapy in intensive care units (ICU) for acute respiratory failure (ARF), its daily clinical practice has not been assessed. We designed a regional survey in ICUs in North-west France to evaluate ICU physicians' clinical practice with HFNC. MATERIALS AND METHODS: We sent an observational survey to ICU physicians from 34 French ICUs over a 6-month period in 2016-2017. The survey included questions regarding the indications and expected efficiency of HFNC, practical aspects of use (initiation, weaning) and satisfaction. Comparisons between junior and senior ICU physicians were performed using a Fischer exact test. RESULTS: Among the 235 ICU physicians contacted, 137 responded (58.3%) all of whom regularly used HFNC. Hypoxemic ARF was considered a good indication for HFNC by all 137, but only 30% expected HFNC success (i.e., avoiding intubation in at least 60% of cases). Among hypoxemic indications, 30% of juniors considered acute pulmonary edema a good indication versus 74% of seniors (p < 0.0001). Hypercapnic ARF was considered a good indication by 33% with only 2% expecting HFNC success. A need for conventional oxygen therapy >/= 6 L/min justified HFNC therapy for 40% and >/= 9 L/min for 39% of responders. 58% of ICU physicians started HFNC therapy with a FiO2 >/= 50% and 28% with a gas flow >/= 50 L/min. Practices for HFNC weaning were heterogeneous: 48% considered a FiO2
Disciplines :
Anesthesia & intensive care
Author, co-author :
Besnier, Emmanuel
Hobeika, Sinad
NSeir, Saad
Lambiotte, Fabien
Du Cheyron, Damien
Sauneuf, Bertrand
Misset, Benoît ; Université de Liège - ULiège > Département de pharmacie > Département de pharmacie
Tamion, Fabienne
Schnell, Guillaume
Richecoeur, Jack
Maizel, Julien
Girault, Christophe
Language :
English
Title :
High-flow nasal cannula therapy: clinical practice in intensive care units.
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