Crimi, Claudia and Noto, Alberto and Cortegiani, Andrea and Carlucci, Annalisa and Gregoretti, Cesare and Inal-Ince, Deniz and Franssen, Frits M. E. M. E. and Karagiannidis, Christian and Winck, Joao Carlos and Fisser, Christoph and Ergan, Begum and Martin-Loeches, Ignacio and Cysneiros, Ana and Patout, Maxime and Duiverman, Marieke and Nava, Stefano (2025) Practices of high-flow nasal therapy in acute and chronic respiratory failure: the Hi-Flow Survey. BMJ OPEN RESPIRATORY RESEARCH, 12 (1): e003547. ISSN , 2052-4439
Full text not available from this repository. (Request a copy)Abstract
Background High-flow nasal therapy (HFNT) is a widely used non-invasive respiratory support technique, but data on its clinical application remain limited. This study aimed to assess clinicians' self-reported practices, perceptions and barriers regarding HFNT use in acute and chronic respiratory failure.Methods A cross-sectional web-based survey was disseminated among members of the European Respiratory Society's respiratory intensive care, rehabilitation and chronic care, and allied respiratory professionals assemblies from September to November 2023. Descriptive analysis was performed, with results presented as frequencies and percentages.Results A total of 1176 clinicians from 104 countries participated, primarily pulmonologists (78.3%) and respiratory therapists (9.7%). HFNT was most commonly used for de novo acute respiratory failure (56.2%) and interstitial lung disease exacerbations (56.3%), with lower utilisation for chronic obstructive pulmonary disease with hypercapnia (47.4%) and trauma/atelectasis (41.5%). Despite guideline recommendations, 67% of respondents initiated HFNT only after conventional oxygen therapy failure. HFNT was also frequently used for symptom relief in palliative care, despite limited supporting evidence. Respiratory distress was the primary clinical trigger for HFNT initiation, while the ROX (Respiratory Rate-Oxygenation) index was rarely used to guide escalation of care (32%). Barriers to HFNT adoption included equipment costs (23%), lack of funding (22%) and limited clinician knowledge (18%). HFNT use increased during the COVID-19 pandemic (84%), but long-term application for chronic respiratory failure remained rare (16%).Conclusions This survey highlights significant variability in HFNT practices and a disconnect between guidelines and real-world implementation. Addressing financial and educational barriers may improve adherence to evidence-based recommendations.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CANNULA OXYGEN-THERAPY; MECHANICAL VENTILATION; ADVANCED CANCER; MANAGEMENT; DYSPNEA; Surveys and Questionnaires; Non invasive ventilation; COPD Exacerbations; Critical Care; Palliative Care; Interstitial Fibrosis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Mar 2026 14:42 |
| Last Modified: | 24 Mar 2026 14:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/68030 |
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