J Korean Soc Emerg Med.  2021 Oct;32(5):377-385.

Characteristics and effects of high-flow nasal cannula oxygen therapy in patients with heart failure admitted to the emergency department

• Kwon JH
• Cho YS
• Park S
• Lee Y
• Jang HY
• Park J
• Chung H
• Kim SI
• Seo BS
• Sohn YW

Abstract

Objective
This study aimed to compare the effects of high-flow nasal cannula (HFNC) treatment and conventional oxygen therapy (COT) in patients with heart failure (HF) admitted to the emergency department (ED).
Methods
This study was a single-center, retrospective, observational study. The subjects were divided into HFNC and COT groups. The characteristics were compared, and vital signs and arterial blood gas (ABG) results were analyzed. In addition, mortality, intubation rate, intensive care unit (ICU) admission, and length of stay (LOS) were analyzed for clinical outcome.
Results
Among 252 patients, 91 and 161 were treated with HFNC and COT. Two groups showed differences in vital signs, ABG results, and pulmonary edema. The HFNC group showed no difference in mortality and LOS, but more intubation and ICU admission were observed (P=0.005, P<0.001). Due to the changes in vital signs and ABG results, the HFNC group reduced blood pressure, heart rate and respiratory rate, improved SpO₂, increased pH, and decreased PaCO₂.
Conclusion
HFNC therapy effectively improved vital signs and ventilation when administered to relatively unstable patients with HF admitted to the ED.

Keyword

Heart failure; High-flow nasal cannula; Intubation