![]() ![]() Given our TGI results, we reasoned that the beneficial clinical responses to HFNC may be related to the high-flow rates effectively flushing the nasopharyngeal cavity of expiratory gas. Such a therapy, in non-intubated patients, may increase the number of infants that can be sustained without intubation or mechanical ventilation and these infants may be weaned sooner. ![]() 4 The results showed asignificant reduction in CO 2 retention associated with prosthetic dead space washout in spontaneously breathing piglets with oleic acid induced lung injury. In a recent study, we used tracheal gas insufflation (TGI) with CPAP in lung injured piglets using a specially designed endotracheal tube to allow for insufflation of fresh gas flow (No. We hypothesized that the mechanism of gas exchange with HFNC is associated with the washout of nasopharyngeal anatomical dead space in addition to the potential impact of positive airway pressure generation. Given the paucity of translational research investigating the mechanism of action of HFNC, we sought to investigate this mechanism further. 3 The use of HFNC in place of conventional methods has been controversial and as yet not well documented in the literature as being more effective than CPAP. High-flow nasal cannula (HFNC) (>2 liters per minute, (lpm)) has been proposed by some physicians as an alternative to CPAP in maintaining infants without the need for intubation and mechanical ventilation. Therefore, it is thought that if CO 2 retention during CPAP can be reduced or eliminated, many infants can be spared potential lung injury and subsequent chronic lung disease induced by mechanical ventilation. ![]() Hypercapnia, or apnea that may be secondary to hypercapnia, are cited as some of the more common reasons for progressing to more invasive forms of ventilatory support. 1, 2 Some essential clinical criteria to remain on CPAP are effective spontaneous respiratory effort and CO 2 elimination. Continuous positive airway pressure (CPAP) is often a preferred intervention over mechanical ventilation with neonatal respiratory distress syndrome in that oxygenation is improved and lung volume is recruited while supporting spontaneous ventilatory efforts. ![]()
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