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Optiflow™ system set-up. a, Optiflow™ RT034 cannula; b, heater delivery tube RT241; c, MR880 heated humidifier; d, laptop interface; e, pressure transducer.
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AEP280F1: Optiflow™ system set-up. a, Optiflow™ RT034 cannula; b, heater delivery tube RT241; c, MR880 heated humidifier; d, laptop interface; e, pressure transducer.

Mentions: Before performing measurements, correct placement of the catheter was confirmed using end-tidal carbon dioxide (CO2) monitoring. If necessary, the catheter was suctioned and manipulated until a clear respiratory trace was achieved. A visual check was also performed to locate the tip of the catheter behind the uvula. The catheter was then connected to the Honeywell precision pressure transducer (PPT-0001 DWWW2VA-B, Honeywell International Ltd, NJ, USA) using a laptop computer interface (Figs 1 and 2). The Optiflow™ system (MR880 heated humidifier, RT241 heated delivery tube, Fisher and Paykel Healthcare Ltd, Auckland, New Zealand) with an air/oxygen blender (Bird high-flow blenders, Cardinal Healthcare, IL, USA) was used for all measurements.

Nasal high-flow therapy delivers low level positive airway pressure

Parke R, McGuinness S, Eccleston M - Br J Anaesth (2009)

Bottom Line: Low level positive pressure was demonstrated with NHF at 35 litre min(-1) with mouth closed when compared with a facemask.Airway pressure was significantly higher when breathing with mouth closed compared with mouth open (P

Affiliation: Cardiothoracic and Vascular Intensive Care Unit, Level 4, Building 32, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand. rparke@adhb.govt.nz

ABSTRACT

Background: The aim of this prospective study was to determine whether a level of positive airway pressure was generated in participants receiving nasal high flow (NHF) delivered by the Optiflow system (Fisher and Paykel Healthcare Ltd, Auckland, New Zealand) in a cardiothoracic and vascular intensive care unit (ICU).

Methods: Nasopharyngeal airway pressure was measured in 15 postoperative cardiac surgery adult patients who received both NHF and standard facemask therapy at a flow rate of 35 litre min(-1). Measurements were repeated in the open mouth and closed mouth positions. Mean airway pressure was determined by averaging the pressures at the peak of inspiration of each breath within a 1 min period, allowing the entire pressure profile of each breath to be included within the calculation.

Results: Low level positive pressure was demonstrated with NHF at 35 litre min(-1) with mouth closed when compared with a facemask. NHF generated a mean nasopharyngeal airway pressure of mean (SD) 2.7 (1.04) cm H(2)O with the mouth closed. Airway pressure was significantly higher when breathing with mouth closed compared with mouth open (P

Conclusions: This study demonstrated that a low level of positive pressure was generated with NHF at 35 litre min(-1) of gas flow. This is consistent with results obtained in healthy volunteers. Australian Clinical Trials Registry www.actr.org.au ACTRN012606000139572.

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