12/6/2023 0 Comments Vapotherm high flow nasal cannula![]() “HFNC may cause unwanted complications during eating and swallowing,” (Allen & Galek, 2020).The “effects on swallowing are unclear,” (Flores, et al., 2019, p522).HFNC is common, but the “impact on the respiratory-swallowing sequence has not been closely researched, and, therefore, its impact on initiation of safe oral intake is in question…,” per Kortney Eng and colleagues (2019, p 1519).Or, you may start getting confused when you read: “Nasal high-flow may allow continuation of oral intake without aspiration during oxygen therapy (p 915).” That last one was really a stretch of a conclusion by Sanuki and colleagues (2017), but more on research problems later.“Among healthy adults, regardless of age, saliva swallow frequency was not significantly affected by HFNC at any flow.” (Alshuwaikhat, et al., 2020).Many articles refer to the availability of the mouth, as these systems do not require a face mask. “HFNC’s value is not limited to ventilation and oxygenation, as it may also allow for oral feeding”(Alshuwaikhat, et al., 2020).If you have reviewed just a few articles, you may see the following quotes: So, back to this lack of definitive answers to our clinical question about high-flow nasal cannula (HFNC)… This file is made available under the Creative Commons CC0 1.0 Universal Public Domain Dedication. Humidification can reduce discomfort, sinus pain, and airway dryness, which can all occur with traditional oxygen delivery through a standard plastic nasal cannula. This air is heated to body temperature (37°) and humidified ( 100% relative humidity / 44 mg H2O per liter) and contains a percentage of oxygen gas (i.e., FiO2 or Fraction of Inspired Oxygen) (Parke, et al., 2011). It delivers high airflows of up to 60-70 liters per minute (lpm). It is an oxygen delivery device with a wide-bore silicon nasal cannula (filling about 50% of the internal diameter of the nares per Parke, et al., 2009). Let’s start with a description of High-Flow Nasal Cannula (HFNC): We want to do what is best for our patients in intensive care units (ICU) around the world. Speech-language pathologists (SLPs) want evidence-based answers, and we want them now. Coghlan & Skoretz (2017, p78) also lamented about the “paucity of the literature” regarding starting oral feeding when someone is on a high-flow nasal cannula. James Coyle, PhD, CCC-SLP, BCS-S in a November, 2020 post. “There is no rule of thumb for this question,” responded Dr. Thank you to Sheri Rosen, MA, CCC-SLP for providing this pdf of guidelines and references for the pediatric population! See Addendum below (before the references) for pediatric guidelines adapted from the framework guidelines presented in this article. ![]() ![]() NOTE: this article addresses high-flow nasal cannula (HFNC) for adults. There have been many similar questions in online discussion groups, especially during this 2020 COVID-19 pandemic. Vapotherm worked with the CDC and FDA to revise the operating manual and reduce risk to patients, and the 2000i was reintroduced on 1 February 2007.High-Flow Nasal Cannula (HFNC): Does it increase dysphagia & aspiration risk?īy Karen Sheffler, MS, CCC-SLP, BCS-S of Can I feed my patient when she is on high-flow nasal cannula (HFNC) with FiO2 of 65% and flow rate of 60 liters per minute (lpm)? I have concerns that the high airflow will increase the risk of aspiration. Vapotherm issued a recall of all 2000i devices on 13 October 2005. In 2005, contaminated Vapotherm 2000i respiratory gas humidification devices were associated with an outbreak of Ralstonia mannitolilytica bacteria in children in the United States. In November 2015 Vapotherm announced its own model of medical air compressor, specifically to be used with their flagship Precision Flow device. Through an agreement with Praxair, Vapotherm provides a Precision Flow model specially calibrated specifically for 80:20 heliox gas for use in patients who may benefit from heliox therapy. The Precision Flow is currently Vapotherm's flagship capital unit and is the premier medical device for providing high flow therapy. In 2009, Vapotherm released a new flagship product replacing the Vapotherm 2000i (that had been recalled in 2005, and then re-approved for use in the market in 2006) boasting a completely integrated electronic flow meter and electronic blender, as well as an internal oxygen analyzer. is a publicly held corporation based in Exeter, New Hampshire that was founded in 1999 as a medical device manufacturer after creating the first heated and humidified high flow therapy nasal cannula system.
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