• Patricia S Bramati, Ahsan Azhar, Rida Khan, Margarita Tovbin, Alex Cooper, Imelda Pangemanan, Bryan Fellman, and Eduardo Bruera.
• Department of Palliative Care (P.S.B., A.A., R.K., M.T., A.C., I.P., E.B.), Rehabilitation and Integrative Medicine, Houston, Texas, USA.
• J Pain Symptom Manage. 2023 Apr 1; 65 (4): e369e373e369-e373.

ContextHigh flow nasal cannula (HFNC) is frequently used to manage dyspnea in patients with cancer near the end of life. Because HFNC is restricted to the in-patient setting, patients on HFNC need to be liberated from it to be discharged from the hospital.ObjectivesThe purpose of this study is to assess the rate of successful liberation from HFNC in a palliative and supportive care unit (PSCU).MethodsThe study is a retrospective chart review of all 374 adult patients with cancer on HFNC admitted to a palliative and supportive care unit at a tertiary medical center from January 1, 2018 to December 31, 2020. We determined the proportion of patients who were liberated from HFNC (by day three and overall) and the proportion of patients discharged alive.ResultsThe mean age of the patients was 64, 54% were male and 73% were white. Only 16% (95% CI: 13-20) of the patients were discharged alive. Liberation from HFNC by day three and overall was accomplished in 23% and 25% of the patients respectively. Comparing the patients who could be liberated from HFNC vs. those who could not by day three, 38% vs. 9% were discharged alive respectively; and overall, 62% vs. 1% respectively (P < 0.001 in both cases).ConclusionOnly a minority of patients with cancer at the end of life can be liberated from HFNC, and only a minority are discharged alive. This information is important when discussing goals of care with patients and their families before initiating HFNC.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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