Heated High-Flow Nasal Cannula for the Treatment of Unintended Perioperative Hypothermia: A Feasibility Study

There are many established strategies to target normothermia in the perioperative period; however, hypothermia remains a common occurrence and can have significant impacts on patient outcomes, unanticipated admissions, and postanesthesia care unit (PACU) throughput. This pilot study serves to shed light on the effectiveness of using high-flow nasal cannula (HFNC) as an alternative to a Bair Hugger (BH). This pilot study compares 10 patients warmed to normothermia with HFNC in the PACU with 15 patients warmed with traditional BH. Patients in the HFNC group reached the goal temperature of 36°C 9.1 minutes faster than the BH group. However, these findings were not statistically significant (mean time: 72.1 minutes vs 81.2; p = 0.247). In addition, phase 1 recovery times were about 8 minutes longer in the HFNC group compared with the BH group but were also not statistically significant (mean time: 180.8 minutes vs 172.4; p = 0.338). Based on the initial data, HFNC may play an important role in the future by making PACU rewarming more efficient and therefore having a huge impact on PACU discharge times, unanticipated hospital admissions, delayed emergence from anesthesia, and morbid cardiac events. Further large scale, randomized control studies need to be done to investigate HFNC as an alternative rewarming method for hypothermic patients in the PACU.