High-flow nasal oxygen in the perioperative setting: A narrative review

Area of Science:

• Anesthesiology
• Respiratory Medicine
• Critical Care

Background:

• High-flow nasal oxygen (HFNO) is increasingly used in perioperative care beyond the ICU.
• It delivers heated, humidified oxygen at precise concentrations and high flow rates.
• HFNO offers physiological benefits including dead space washout and reduced inspiratory effort.

Purpose of the Study:

• To review the evidence supporting HFNO use in different perioperative phases.
• To compare HFNO with conventional oxygen therapy.
• To discuss limitations and future research directions for HFNO in perioperative settings.

Main Methods:

• Systematic review of current literature on HFNO in perioperative respiratory management.
• Analysis of physiological mechanisms of HFNO.
• Comparison of HFNO outcomes with conventional oxygen therapy and non-invasive ventilation.

Main Results:

• HFNO improves oxygenation and prolongs safe apnoea time compared to conventional therapy.
• It is effective in high-risk patients (e.g., obese, cardiothoracic surgery) and during procedural sedation.
• HFNO may decrease the need for non-invasive ventilation postoperatively and improve patient comfort.

Conclusions:

• HFNO is a valuable, well-tolerated option for perioperative respiratory support.
• Further research is needed to optimize patient selection and standardize flow settings.
• Personalized perioperative oxygenation strategies integrating HFNO are warranted.