High-flow nasal cannula oxygen therapy versus non-invasive ventilation in adult patients with acute respiratory failure

Background
Respiratory failure is when the respiratory system fails to perform one or both gas exchange functions: oxygenation and carbon dioxide elimination. It may be classified as either hypoxemic or hypercapnic.


Aim
Evaluate the impact of a high-flow nasal cannula (HFNC) in treating acute respiratory failure adult patients in the respiratory intensive care unit compared with non-invasive positive pressure ventilation.


Patients and methods
The study was a clinical observational therapeutic study of patients with acute respiratory failure of respiratory causes who were admitted to the respiratory intensive care unit at Kafr El-sheikh University Hospital from January 2023 to 2024. This study included 71 patients. Sixteen patients were excluded due to incomplete data or receiving therapy for less than 2 h. The remaining 55 patients were divided into two groups: group A (HFNC group) with 35 patients using a HFNC, and group B [non-invasive ventilation (NIV) group] with 20 patients using non-invasive positive pressure ventilation (BiPAP mode).


Results
The study included 55 patients, with 26 males and 29 females, and a mean age of 62.26 ± 15.56. Both groups showed no significant differences in outcomes, including success or failure, intubation, discharge to the ward, length of ICU stay, length of hospital stay, and mortality.


Conclusion
Both modalities, NIV and HFNC, were effective in treating acute respiratory failure, with similar outcomes for hospital and ICU stays and mortality. The application of NIV was superior to HFNC regarding oxygenation and ventilation (exceptionally high partial pressure of carbon dioxide level).