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Practice of High-Flow Nasal Cannula in Patients with Mild to Moderate COPD Among Healthcare Providers in Saudi
Abdulelah M Aldhahir1,2, Mohammed M Alyami3, Osama Alanazi3
1Respiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia.
Background:
High-flow nasal cannula (HFNC) has emerged as a promising non-invasive oxygen therapy for patients with chronic obstructive pulmonary disease (COPD), particularly those with mild to moderate hypercapnia. Despite its growing use, no studies in Saudi Arabia have explored healthcare providers' clinical practices or perceived barriers related to HFNC application in this patient population. This study aimed to assess the current clinical use and implementation challenges of HFNC among physicians and respiratory therapists (RTs) in Saudi Arabia.
Methods:
A cross-sectional survey was conducted among physicians and RTs across Saudi Arabia from October 27, 2024, to May 20, 2025. The survey, distributed via several channels, collected data on HFNC practices, initial settings, weaning approaches, and perceived barriers. Descriptive statistics presented as frequencies and percentages. Chi-square tests were used to assess differences between physicians and RTs, with a significance level set at p < 0.05.
Results:
A total of 1724 healthcare providers completed the survey, including 636 (36.9%) physicians and 1,088 (63.1%) RTs. Significant variations were found between the two groups regarding who initiates HFNC, preferred flow rates, and temperature settings (p < 0.05). The most common flow rate selected was 30-40 L/min (47.2%), and initial FiO2 levels typically ranged between 41% and 60%. Regarding weaning, 43% of respondents reduced flow by 5-10 L/min every 2-4 hours, and 48% disconnected HFNC when the flow rate dropped below 20 L/min. The primary barriers reported by both groups included lack of standardized protocols, insufficient training, and limited HFNC knowledge.
Conclusion:
There is an inconsistent clinical practice regarding HFNC use in mild to moderate COPD among healthcare providers in Saudi Arabia. Addressing knowledge gaps and standardizing protocols may enhance the effective implementation of HFNC therapy and improve patient outcomes.
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