Effect of very-high-flow nasal therapy on airway pressure and end-expiratory lung impedance in healthy volunteers

Rachael L Parke, Andreas Bloch, Shay P McGuinness

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BACKGROUND: Previous research has demonstrated a positive linear correlation between flow delivered and airway pressure generated by high-flow nasal therapy. Current practice is to use flows over a range of 30?60 L/min; however, it is technically possible to apply higher flows. In this study, airway pressure measurements and electrical impedance tomography were used to assess the relationship between flows of up to 100 L/min and changes in lung physiology. METHODS: Fifteen healthy volunteers were enrolled into this study. A high-flow nasal system capable of delivering a flow of 100 L/min was purpose-built using 2 Optiflow systems. Airway pressure was measured via the nasopharynx, and cumulative changes in end-expiratory lung impedance were recorded using the PulmoVista 500 system at gas flows of 30?100 L/min in increments of 10 L/min. RESULTS: The mean age of study participants was 31 (range 22?44) y, the mean ? SD height was 171.8 ? 7.5 cm, the mean ? SD weight was 69.7 ? 10 kg, and 47 were males. Flows ranged from 30 to 100 L/min with resulting mean ? SD airway pressures of 2.7 ? 0.7 to 11.9 ? 2.7 cm H2O. A cumulative and linear increase in end-expiratory lung impedance was observed with increasing flows, as well as a decrease in breathing frequency. CONCLUSIONS: Measured airway pressure and lung impedance increased linearly with increased gas flow. Observed airway pressures were in the range used clinically with face-mask noninvasive ventilation. Developments in delivery systems may result in this therapy being an acceptable alternative to face-mask noninvasive ventilation.
Original languageEnglish
Pages (from-to)1397 - 1403
Number of pages7
JournalRespiratory Care
Issue number10
Publication statusPublished - 2015

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