Clinical Outcomes Of High-Flow Nasal Oxygen Therapy In Acute Respiratory Failure In The Emergency Setting.

Original Article

Abstract

Background: The Emergency Department (ED) Now Uses High-Flow Nasal Oxygen (HFNO) Treatment As An Advanced Approach To Treating Patients Experiencing Acute Respiratory Failure. HFNO Provides Warm Humidified Oxygen Through Nasal Channels With High Flow Rates Which Builds Oxygenation While Decreasing Respiratory Work And Providing Better Comfort To The Patient.

Objectives: to determine both the effectiveness and various clinical outcomes achieved through high-flow nasal oxygen therapy when treating patients with acute respiratory failure in emergency departments.

Study design: A Retrospective Study.

Place and duration of study: Department of Diabetes, Endocrinology & Metabolic diseases, Hayat Abad Medical Complex, Peshawar, Pakistan from jan 2023 to jan 2024

Methods: Adults aged ≥18 years who received high-flow nasal oxygen (HFNO) for acute respiratory failure were eligible. Investigators abstracted demographics, baseline clinical measures (vital signs, arterial blood gas, SpO₂/FiO₂), HFNO settings, and clinical response, and recorded outcomes of endotracheal intubation, ICU admission, and in-hospital mortality. Continuous variables were summarized as mean±SD (or median [IQR]) and compared using Student’s t-test (or Mann–Whitney U when non-normal); categorical variables used χ² tests (Fisher’s exact when appropriate). Two-sided p<0.05 denoted statistical significance.

Results: Among 100 patients, the mean (SD) age was 64.7 (13.2) years, and 58% were male (n=58). Pneumonia was the leading etiology of acute respiratory failure (34%), followed by COPD exacerbation (22%) and pulmonary edema (19%). Within 2 hours of HFNO initiation, oxygenation and respiratory rate improved (SpO₂ 85.2% ± 5.4 to 94.7% ± 3.8; p<0.001). During hospitalization, 18.2% required endotracheal intubation and 36.5% were admitted to the ICU; overall in-hospital mortality was 12.8%.

Conclusion: Strategy with high-flow nasal oxygen helps security along with effectiveness to treat acute respiratory failure inside emergency departments. Hospital patients receive better oxygenation through this therapy while clinicians need less invasive ventilation and may avoid sending patients to intensive care units. Better clinical results accompany rapid patient reactions to HFNO therapy. More prospective study should be done to verify and extend the information discovered.