High-flow nasal cannula: an alternative in the management of respiratory failure

Cánula nasal de alto flujo: una alternativa en el manejo de la insuficiencia respiratoria

High-flow oxygen therapy (HFO) has emerged as a promising therapeutic option, positioning itself between conventional low-flow oxygen therapy and noninvasive ventilatory support. This system delivers humidified and heated oxygen at high flows (up to 60 L/min), generating positive airway pressure, reducing anatomical dead space and improving gas exchange efficiency. Unlike other modalities, its design without a face mask increases comfort and tolerance in patients, facilitating their treatment adherence (1).

The challenge posed by the SARS-CoV-2 pandemic led to a global health crisis, underscoring the need to optimize technological resources for managing acute respiratory failure. Initially, the stepwise approach from standard oxygen therapy to invasive mechanical ventilation showed a negative impact on morbidity and mortality, especially in patients with severe hypoxemia. This prompted the adoption of noninvasive alternatives, such as HFO and noninvasive ventilation (NIV), to avoid early intubation (1,2).