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Nasal high flow reduces dead space.

Winfried Möller1,2, Sheng Feng3, Ulrike Domanski4

  • 1Comprehensive Pneumology Center, German Center for Lung Research, Munich, Germany; moeller@helmholtz-muenchen.de.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|November 19, 2016
PubMed
Summary
This summary is machine-generated.

Nasal high flow (NHF) therapy effectively clears airway dead space, reducing rebreathing and improving ventilation efficiency. This study demonstrates NHF’s dose-dependent effect on reducing expired air in the upper airways.

Keywords:
Kryptondead spacenasal high flowrebreathingrespiratory supportupper airways

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Area of Science:

  • Respiratory Physiology
  • Medical Devices

Background:

  • Nasal high flow (NHF) therapy is increasingly used for respiratory support.
  • The mechanism of NHF's ventilatory support is thought to involve dead space clearance.
  • This study investigates the dose-dependent effect of NHF on upper airway dead space and rebreathing.

Purpose of the Study:

  • To determine if NHF therapy clears upper airway dead space in a dose-dependent manner.
  • To quantify the reduction in rebreathing during NHF therapy.
  • To explore the extent to which NHF affects dead space clearance.

Main Methods:

  • A randomized crossover study involving 10 healthy volunteers and 3 tracheotomized patients.
  • Scintigraphy with 81mKrypton gas was used in volunteers to assess gas clearance.
  • Volumetric capnography and oximetry in tracheotomized patients measured CO2 and O2 in the trachea at varying NHF rates (15, 30, 45 l/min).

Main Results:

  • NHF significantly decreased the clearance half-time of 81mKrypton gas in the nasal cavities, pharynx, and trachea.
  • Clearance rates in nasal cavities increased with higher NHF rates.
  • NHF therapy led to a dose-dependent decrease in tracheal CO2 and a corresponding increase in O2, indicating reduced rebreathing.

Conclusions:

  • NHF therapy effectively clears expired air from the upper airways, reducing dead space.
  • This reduction in dead space decreases rebreathing, thereby enhancing ventilation efficiency.
  • The dead space clearance effect of NHF is flow and time dependent and may extend below the soft palate.