medigraphic.com
ISSN 2594-3006 (Electronic)
ISSN 2007-1752 (Print)
Archivos de Medicina de Urgencia de México

2025, Number 2-3

<< Back Next >>

Arch Med Urg Mex 2025; 17 (2-3)

Asymmetrical high-flow nasal cannula new administration option

Trejo-Rosas S, Mendez-Jesus IA, Sanabria-Cordero D, Silva-Escamilla MC, García-Hernández EA, Martínez-Badajoz A, Rosiles-Sayago A

Language: Spanish
References: 21
Page: 151-157
PDF size: 452.17 Kb.


ABSTRACT

High-flow nasal cannula (HFNC) therapy is undoubtedly a treatment option for acute hypoxemic respiratory failure, used worldwide in both public and private healthcare institutions. This is in addition to numerous other application options. Last year, an interface with one branch of smaller diameter and one branch of larger diameter, the asymmetric cannula (hence its name), became available. Its aim is to optimize the physiological effects of high-flow oxygen therapy by improving positive end-expiratory pressure and carbon dioxide elimination. Currently, some studies indicate that the use of this asymmetric design can increase upper airway pressure and decrease dead space, as well as improve patient comfort during treatment by reducing the work of breathing and minute ventilation.


REFERENCES

  1. Esquinas AM, et al. Noninvasive mechanical ventilation in acuteventilatory failure: rationale and current applications. Sleep MedClin. 2017;12:597–606.

  2. Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS, Nava S, etal. Official ERS/ATS clinical practice guidelines: noninvasive ventilationfor acute respiratory failure. Eur Respir J. 2017;50:1602426.

  3. Davidson AC, Banham S, Elliott M, Kennedy D, Gelder C, GlossopA, et al. BTS/ICS guideline for the ventilatory management ofacute hypercapnic respiratory failure in adults. Thorax. 2016;71 2Suppl.:ii1–35.

  4. Díaz Lobato S, Mayoralas Alises S. New approaches to the treatmentof respiratory failure: high flow therapy. Med Clin (Barc).2016;147:397–8

  5. Mauri T, Turrini C, Eronia N, Grasselli G, Volta CA, Bellani G, et al.Physiologic effects of high-flow nasal cannula in acute hypoxemicrespiratory failure. Am J Respir Crit Care Med. 2017;195:1207–15.

  6. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D,et al. Beneficial effects of humidified high flow nasal oxygen in criticalcare patients: a prospective pilot study. Intensive Care Med.2011;37:1780–6.

  7. Drake MG. High-flow nasal cannula oxygen in adults: an evidence-based assessment. Ann Am Thorac Soc. 2018;15(2):145-155.

  8. Oczkowski S, Ergan B, Bos L, et al. ERS clinical practice guidelines:high-flow nasal cannula in acute respiratory failure. Eur RespirJ. 2022;59(4):2101574.

  9. Garofalo E, Bruni A, Pelaia C, et al. Evaluation of a new interfacecombining high-flow nasal cannula and CPAP. Respir Care.2019;64(10):1231-1239.

  10. Stanislav Tatkov et al. J Appl Physiol (1985). 2023 Feb1;134(2):365-377. doi: 10.1152/japplphysiol.00692.2022. E pub2023 Jan 12.

  11. Boscolo A, Pettenuzo T, Zaratoenllo F, et al. La cánula nasal asimétricade alto flujo funciona de forma similar a la interfaz estándaren pacientes con insuficiencia respiratoria hipoxémica agudapostextubación: un estudio piloto. BMC Pulm Med. 2024;24(1):21.

  12. Slobodf D, Spinelli E, Crotti S, et al. Efectos de una interfaz decánula nasal asimétrica de alto flujo en pacientes hipoxémicos.Crit Care. 2023;27(1):145.

  13. Tommaso Pettenuzzo, Nicolo Sella, Francesco Zarantonello, et al.Patients Comfort During Highflow Oxygen Therapy with AsymmetricalProngs: Te Comfoxy-1 Trial. DOI:https://doi.org/10.212023/rs.3.rs-8496018/v1. Juanary 19th, 2026.

  14. Lara Pisani, Maria Laura Vega, Elisa Ageno, et al. Effects of asymmetricnasal high-flow annula on carbón dioxide in hypercapnuicpatients: A randomised crossover physiological pilot study, PulmonologyJournal 31:1, 2411813, DOI:10.1080/25310429.2024.2411813.

  15. Rittayamai N. The Physiologic Effects of Asymmetrical VersusConventional High-flow Nasal Cannula in Acute RespiratoryFailure: A Randomized Crossover Study. ClinicalTrials.gov IDNCT06204276. Siriraj Hospital; 2024.

  16. Tiruvoipati R, et al. A comparison of conventional high-flow nasalcannula vs the duet high-flow nasal cannula in extubated patients:a randomized crossover trial. Eur J Med Res. 2025.

  17. Pantazopoulos I, et al. The Effect of Asymmetrical vs. SymmetricalHigh Flow Nasal Cannula on the Work of Breathing: A RandomisedCross-over Study. ClinicalTrials.gov ID NCT07066566. LarissaUniversity Hospital; 2025.

  18. Zanaga A. Il comfort dei pazienti durante la terapia con ossigenoterapiaad alto flusso con cannule asimmetriche - il trial Comfoxy-1[tesis doctoral]. Università di Padova; 2024/2025.

  19. Colombo SM, et al. Use of high flow nasal cannula in patientswith acute respiratory failure in general wards under intensivistssupervision: a single center observational study. Respir Res.

  20. 2022.20. Rochwerg B, et al. The role for high flow nasal cannula as a respiratorysupport strategy in adults: a clinical practice guideline. IntensiveCare Med. 2020;46(12):2226-2237.

  21. Begum Ergan, Bisar Ergun, et al. Thorac Res Pract 2025;26(6):374-379. DOI: 10.4274/ThoracResPract.2025.2025-3-2




2020     |     www.medigraphic.com