High-flow nasal cannula versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a retrospective study.

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently present with acute hypercapnic respiratory failure (AHRF). While non-invasive ventilation (NIV) remains the fist-line therapy, high-flow nasal cannula (HFNC) offers a potential alternative.

Methods: This retrospective cohort study compared the clinical effectiveness and safety of HFNC versus NIV as initial respiratory support in 100 consecutive patients with AECOPD and AHRF (PaCO2 > 45 mmHg, pH 7.

Lung Ultrasound After COVID-19: A Pivotal Moment for Clinical Integration-Navigating Challenges and Seizing Opportunities.

Lung ultrasound (LUS) has emerged as a valuable bedside decision-making tool, particularly since the COVID-19 pandemic, with applications in diagnosing pneumonia, managing fluid, and monitoring interstitial lung diseases (ILDs) and acute respiratory distress syndrome (ARDS), ultimately improving patient outcomes. Its repeatability, environmental safety, and reduced radiation exposure make it ideal for vulnerable populations and resource-limited settings. However, challenges such as inadequate documentation and a lack of standardized reporting formats limit its widespread adoption.

Physiological effects and clinical evidence of high-flow nasal cannula during acute exacerbation in COPD patients: A narrative review.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. During severe exacerbations, COPD patients may develop acute respiratory failure (ARF), often necessitating hospital admission due to impaired gas exchange. In COPD patients, the diaphragm is subjected to an increased workload resulting from airflow limitations and geometric changes in the thorax due to pulmonary hyperinflation.

Debate on the Role of Eccentric Contraction of the Diaphragm: Is It Always Harmful?

The diaphragm is the primary muscle involved in the ventilatory pump, making it a vital component in mechanical ventilation. Various factors in patients who require mechanical ventilation can lead to the deterioration of the diaphragm, which is associated with increased mortality. This deterioration can arise from either excessive or insufficient support due to improper adjustment of ventilation programming variables.

High-flow nasal cannula and in-line aerosolised bronchodilator delivery during severe exacerbation of asthma in adults: a feasibility observational study.

Background: Asthma is a common chronic respiratory disease affecting 1-29% of the population in different countries. Exacerbations represent a change in symptoms and lung function from the patient's usual condition that requires emergency department (ED) admission. Recently, the use of a High-Flow Nasal Cannula (HFNC) plus an in-line vibrating mesh nebulizer (VMN) for aerosol drug delivery has been advocated in clinical practice.

Effect of high-flow nasal cannula at different flow rates on diaphragmatic function in subjects recovering from an acute exacerbation of COPD: a physiological prospective pilot study.

Background: Noninvasive ventilation (NIV) is widely employed as the initial treatment for patients with chronic acute exacerbation of obstructive pulmonary disease (AECOPD). Nevertheless, high-flow nasal cannula (HFNC) has been increasingly utilized and investigated to mitigate the issues associated with NIV. Flow rate may play a significant role in diaphragmatic function among subjects recovering from AECOPD.

Noninvasive respiratory support in the perioperative setting: a narrative review.

The application of preoperative noninvasive respiratory support (NRS) has been expanding with increasing recognition of its potential role in this setting as a physiological optimization for patients with a high risk of developing atelectasis and postoperative pulmonary complications (PPC). The increased availability of high-performance anesthesia ventilator machines providing an easy way for NRS support in patients with reduced lung function should not be under-evaluated. This support can reduce hypoxia, restore lung volumes and theoretically reduce atelectasis formation after general anesthesia.

Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study.

Background: Lung ultrasound has demonstrated its usefulness in several respiratory diseases management. One derived score, the Lung Ultrasound (LUS) score, is considered a good outcome predictor in patients with Acute Respiratory Failure (ARF). Nevertheless, it has not been tested in patients undergoing non-invasive respiratory support (NIRS).

Delivery of Aerosolized Bronchodilators by High-Flow Nasal Cannula During COPD Exacerbation.

Background: Bronchodilator delivery via a high-flow nasal cannula (HFNC) has generated interest in recent years. The efficacy of in-line vibrating mesh nebulizers with an HFNC during COPD exacerbation is limited. The aim of this study was to evaluate the clinical response of subjects with COPD exacerbation who require bronchodilator therapy (anticholinergic and β-agonist) by using a vibrating mesh nebulizer in line with an HFNC.

Combined Noninvasive Respiratory Support Therapies to Treat COVID-19.

Background: The roles of high-flow nasal cannula (HFNC) and CPAP in coronavirus disease 2019 (COVID-19) are controversial. The objective of the study was to evaluate the impact of the application of a noninvasive respiratory support algorithm on clinical outcomes in subjects with COVID-19 and with acute respiratory failure.

Methods: We performed a single-center prospective observational study of subjects with respiratory failure from COVID-19 managed with HFNC and with CPAP plus HFNC (combined therapy).