• Emerg Med Australas · Dec 2015

    Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department.

    • Nerida Bell, Claire L Hutchinson, Timothy C Green, Eileen Rogan, Kendall J Bein, and Michael M Dinh.
    • Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
    • Emerg Med Australas. 2015 Dec 1; 27 (6): 537-541.

    ObjectivesThe aim of the study was to determine if oxygen delivered through humidified high flow nasal cannulae (HHFNC) reduced the need for escalation in ventilation management and work of breathing in the ED patients presenting with acute undifferentiated shortness of breath compared with standard oxygen therapy.MethodsThis was an unblinded randomised control trial conducted at two hospital EDs in Sydney, Australia. Eligible patients presenting with shortness of breath were randomised to HHFNC or standard oxygen therapy. Primary outcomes were the need to escalate ventilation therapy or a reduction in respiratory rate of 20% or more within 2 h of commencement.ResultsOne hundred patients were enrolled in the trial. The intervention group receiving HHFNC was associated with a higher proportion of patients with a reduced respiratory rate at 2 h (66.7% vs 38.5%, P = 0.005) and a lower proportion of patients requiring escalation in ventilation therapy (4.2% vs 19%, P = 0.02) compared with standard oxygen therapy.ConclusionsThe use of high flow nasal cannula oxygenation was associated with improved respiratory state in selected patients presenting to the ED with acute undifferentiated shortness of breath.© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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