ネイ ザル ハイフロー。 ネーザルハイフローの看護に必要な観察項目・設定の仕方を解説【一人でできる】

【ネーザルハイフロー】誰でもわかる基礎知識~Ⅱ型呼吸不全の看護~

🤐 Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: A multicenter observational study [Journal pre-proof]. Am J Respir Crit Care Med. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. 2013; 58 4 : 597-600. 12 Variation in Aerosol Production Across Oxygen Delivery Devices in Spontaneously Breathing Human Subjects. 今回の論文は、Respiratory Investigation誌に投稿された「 成人におけるハイフロー鼻カニューレ酸素療法:日本における横断的多施設サーベイ(The clinical practice of high-flow nasal cannula oxygen therapy in adults: A Japanese cross-sectional multicenter survey)」(Ito J, et al. Assessment of the potential for pathogen dispersal during high-flow nasal therapy [published online ahead of print, 2020 Apr]. 2014; 59 4 : 485—90. 2016 Oct 18;316 15 :1565-1574. 25 cm H 2O, 2. Nasal High-Flow Therapy for Primary Respiratory Support in Preterm Infants. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D et al. High-Flow Nasal Interface Improves Oxygenation in Patients Undergoing Bronchoscopy. ICUにおける主なNHFの臨床試験 1 Roca O, Riera J, Torres F, et al. Mechanisms of nasal high flow on ventilation during wakefulness and sleep. ハイフローセラピーの原理と効果」 三枝勉, 古田島太, 磨田裕(埼玉医科大学国際医療センター集中治療科) 呼吸器ケア13(1):16-20 2015 「Theme 2 適応患者はどこにいる? Jeong JH, Kim DH, Kim SC, Kang C, Lee SH, Kang TS et al. High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection [published online ahead of print, 2020 Jul 23]. High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. 7 Lemiale V, Mokart D, Mayaux J, et al. No evidence of increasing COVID-19 in health care workers after implementation of high flow nasal cannula: A safety evaluation [published online ahead of print, 2020 Oct 7]. The Impact of High-Flow Nasal Cannula Use on Patient Mortality and the Availability of Mechanical Ventilators in COVID-19 [published online ahead of print, 2020 Oct 13]. Nasal high flow clears anatomical deadspace in upper airway models. Use of High-Flow Nasal Cannula for Acute Dyspnea and Hypoxemia in the Emergency Department. Leung CCH, Joynt GM, Gomersall CD, et al. Evaluation of a humidified nasal high flow oxygen system, using oxygraphy, capnography and measurement of upper airway pressures. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D et al. Changes in arterial blood gases after use of high-flow nasal cannula therapy in the ED. Li J, Fink JB, Ehrmann S. Intensive Care Medicine 45 5 : 563? 2015 Jun 16;313 23 :2331-9. Patel M, Gangemi A, Marron R, et al. Journal of Hospital Infection 「…HFNCは、飛沫や接触感染の潜在的リスクを高めることはないと 考えられる。

The effects of a 2-h trial of high-flow oxygen by nasal cannula versus Venturi mask in immunocompromised patients with hypoxemic acute respiratory failure: a multicenter randomized trial. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. Humidified High Flow Nasal Oxygen During Respiratory Failure in the Emergency Department: Feasibility and Efficacy. "High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion. Aerosol dispersion during various respiratory therapies: A risk assessment model of nosocomial infection to health care workers. Roca O, Riera J, Torres F, Masclans JR. American Journal of Respiratory and Critical Care Medicine 「…健康な人では、非侵襲的換気 NIV またはHFNCによって、室内 空気または非加湿酸素状態よりも高濃度のエアロゾルが、発生することはありませんでした。

高流量鼻カニュラ酸素療法

🤞 High-flow nasal oxygen: a safe, efficient treatment for COVID-19 patients not in an ICU [published online ahead of print, 2020 Sep 9]. Oct 2016; 316 15 :1565—74. 」 - Gershengorn et al. Jermy M, Spence C, Kirton R, et al. Peters S, Holets S, Gay P. British Journal of Anaesthesia 118 3 : 444? N Engl J Med: 22 Sep 2016; 375:1142-51 ・ICU 表. Available from: [Accessed 18 Sep 2020]. 2.精度の高いFiO 2 呼吸生理学的には、通常の鼻カニューラやオキシマイザー TMカニューラに比べて死腔ウォッシュアウトが可能となり、正確なFiO 2を実現できるのが大きな利点です。

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Coronavirus Disease 2019 COVID-19 Treatment Guidelines. Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Evaluation of a high-flow nasal oxygen delivery system using oxygraphy, capnography and measurement of upper airway pressures. 」 - Li et al. Annals of the American Thoracic Society 「…COVID-19関連の呼吸不全でのNHFの使用を(潜在的曝露リスクを理由に)当初認めていなかった医療機関が、使用を許可し始めています。 専門家の推奨事項 International Society of Aerosols in Medicine ISAM などの主要な国際学会に属する専門家による最近の発表では、NHFおよびその他の非侵襲的呼吸補助の使用 または不使用 について意見が述べられています。

【呼吸管理学術部会】厚生労働省「新型コロナウィルス感染症診療の手引き」記載の呼吸管理に関する事項について|一般社団法人日本呼吸器学会

🤘 4 Epstein AS, Hartridge-Lambert SK, Ramaker JS, et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. The use of high-flow nasal oxygen in COVID-19 [published online ahead of print, 2020 Apr 20]. 15 Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trial. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. Nasal high-flow versus Venturi mask oxygen therapy after extubation. Apr 2016; 315 13 :1354—61. American Journal of Emergency Medicine 「... ; Vinson, Brett; Stidham, Greg 2009-10-01. Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department. Respiratory Care 49 8 : 902? 1Critical Care Research Group, The Prince Charles Hospital and University of Queensland Br J Anaesth. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. ・利点:挿管率や ICU 滞在時間が減る可能性、DNI であっても開始できる ・欠点:ウイルス飛散リスクがある(実験データでは許容されているが、安全性を実証したデータはない) *AないしBを選ぶかは各施設の状況、考え方で判断する. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. 2013; 58 4 : 597—600. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial.。 High-Flow Nasal Cannula Therapy in Do-Not-Intubated Patients with Hypoxemic Respiratory Distress. Journal of Intensive Care Medicine 24 5 : 323? High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. Nasal high-flow versus Venturi mask oxygen therapy after extubation. The Effect of High-Flow Nasal Cannula Oxygen Therapy on Mortality and Intubation Rate in Acute Respiratory Failure: A Systematic Review and Meta-Analysis. Oct 2016; 316 15 :1565—74. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. 2014 Aug 1;190 3 :282-8. High flow through a nasal cannula and CPAP effect in a simulated infant model. Respir Med 2009;103 10 :1400-5. Ritchie JE, Williams AB, Gerard C, Hockey H. Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trial. Li J, Fink JB, Ehrmann S. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Open-label, phase II study of routine high-flow nasal oxygen therapy in cardiac surgical patients. High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. Hui DS, Chow BK, Lo T, et al. ; Zhu, Y; Rojas, J; Hesek, A; Stump, A; Shaffer, T. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. Spentzas, Thomas; Minarik, Milan; Patters, Andrea B. High-Flow Oxygen Therapy in Acute Respiratory Failure. Gershengorn H, Hu Y, Chen J, et al. High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. World Health Organization interim guidance for the Clinical management of COVID-19. 4 Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. Australian guidelines for the clinical care of people with COVID-19. 2 Sztrymf B, Messika J, Bertrand F,, et al. High-Flow Nasal Cannula Versus Conventional Oxygen Therapy After Endotracheal Extubation: A Randomized Crossover Physiologic Study. Thorax 「…試験期間中とその後の14日間において、スワブ検査で陽性とな った者は一人もいなかった…」 Westafer et al. Apr 2016; 315 13 :1354—61. Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. [Epub ahead of print] 4 Jones PG, Kamona S, Doran O, et al. A Randomized Controlled Trial of High-Flow Nasal Oxygen Optiflow as Part of an Enhanced Recovery Program After Lung Resection Surgery. 2016 Oct 18;316 15 :1565-1574. Roca O, Riera J, Torres F, Masclans JR. Pediatric Pulmonology 46 1 : 67—74. 14 Assessment of the potential for pathogen dispersal during high-flow nasal therapy. The effects of flow on airway pressure during nasal high-flow oxygen therapy. Humidified high flow nasal oxygen during respiratory failure in the emergency department: feasibility and efficacy. Am J Respir Crit Care Med. Vianello A, Arcaro G, Molena B, et al. High-Flow Nasal Cannula Therapy in Do-Not-Intubated Patients with Hypoxemic Respiratory Distress. Aerosol Generation from the Respiratory Tract with Various Modes of Oxygen Delivery. Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard JD. 54 cm H 2O, 3. Kaur R, Weiss TT, Perez A, Fink JB, Chen R, Luo F, Liang Z, Mirza S, Li Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19. High-flow oxygen therapy in acute respiratory failure. 2020 Sep 23;24 1 :571. High-Flow Oxygen Therapy in Acute Respiratory Failure. Research in high flow therapy: mechanisms of action. Duan J, Chen B, Liu X, et al. Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis. 3 Corley A, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 COVID-19. 観察事項 条件通りに作動しているか2時間毎に確認し、記録する 設定の確認 酸素流量、酸素濃度、加温加湿のモード・温度(口元が37度になるように設定されている) 機械の管理 外観の異常の有無、アラームの有無、回路接続部の緩みや外れ 基本的にブレンダーにはアラームはなく、漏れなどがあれば、しばらくしてから加温加湿器のアラームが鳴ることがある。 4 Ansari BM, Hogan MP, Collier TJ, et al. 加温加湿による、気道クリアランス能力の最適化 必要物品 酸素アウトレット 空気アウトレット パルスオキシメーター 回路一式 専用鼻カニューレ ディスポーザブル加温加湿器チャンバー バッグバルブマスク 人工呼吸器使用中点検表 人工呼吸器指示・確認表 Y字管 擦式消毒用アルコール製剤 注射用水500ml(点滴用)必要時心電図モニター 適応 新生児:シンディ(流量16Lまで) 小児:酸素ブレンダー( ~30L) 成人:酸素ブレンダー(25~60L)*空気が不要な機器もある 早産児サイズ(最大流量8L体重約1~3kg)新生児サイズ(最大流量8L体重2~8kg) 乳幼児サイズ(最大流量20L体重約3~15kg) 小児サイズ(最大流量25L体重約12~22kg) 方法・留意点• Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. 救急外来における主なNHFの臨床試験 1 Lenglet H, Sztrymf B, Leroy C, et al. Available from: [Accessed 18 Sep 2020]. モニター監視 SpO2値、呼吸数、心拍数 患者の状態 呼吸状態、呼吸音、顔色、チアノーゼの有無、カニューレ装着部の皮膚の状態 小児の場合必要時呼吸状態をMPISで点数化する. Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation NIV. Effect of Postextubation High—Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High—Risk Patients. 8 Frat JP, Thille AW, Mercat A, et al. HFNC の設定:SpO 295%(あるいは PaO 2が 70Torr)を目標に FiO 2を設定する。

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抜管後における主なNHFの臨床試験 1 Maggiore SM, Idone FA, Vaschetto R, et al. Hasani A, Chapman TH, McCool D, Smith RE, Dilworth JP, Agnew JE. 2 Rittayamai N, Tscheikuna J, Praphruetkit N, et al. Corley A, Caruana LR, Barnett AG, Tronstad O, Fraser JF. Journal of Perinatology 27 12 : 776? Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. High-flow nasal cannula for COVID-19 patients: risk of bio-aerosol dispersion [published online ahead of print, 2020 Oct z 8. Journal of Hospital Infection 「グラム陰性菌による肺炎患者へのHFNCの使用により、空気汚染 または表面 グラム陰性菌 汚染が増大することはなく、HFNCを使用する際に追加の感染管理対策が必要ないことを示しています。

【呼吸管理学術部会】厚生労働省「新型コロナウィルス感染症診療の手引き」記載の呼吸管理に関する事項について|一般社団法人日本呼吸器学会

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ネーザルハイフローは実際にどのように使われているか?:日経メディカル

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ネーザルハイフロー(Nasal High Flow)とは?【最も大事な機能を解説】

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ネーザルハイフローは肺炎の挿管率を低下させる FLORALI試験|いちにちひとつ

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