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High-flow nasal cannula (HFNC) is becoming the gold standard to treat respiratory distress at any age since it potentially provides several significant clinical advantages. An obstacle to the diffusion of this simple and effective system of oxygen therapy is the impossibility to know the optimal flow rate leading to such advantages that allows the reduction in the respiratory effort without causing hyperinflation. To assist clinicians during HFNC treatment in setting the optimal flow rate and in determining the most relevant parameters related to respiratory mechanics and the effort of the patient, we developed a new programmable data monitoring, acquisition, and elaborating system (Pro_HFNC). The application of Pro_HFNC is fully compatible with HFNC as it is interfaced with patient through a facial mask and two specific catheters. The unavoidable and unpredictable loss of air flow occurring around the contour of the mask is evaluated and compensated by a specific algorithm implemented by Pro_HFNC. Our preliminary clinical trials on pediatric patients treated with HFNC show that Pro_HFNC is actually capable to detect for any specific patient both the lower threshold of the delivered flow beyond which the benefits of HFNC application are reached and all the parameters useful for a complete evaluation of the respiratory profile. Pro_HFNC can really help physicians in setting the optimal flow rate during HFNC treatment, thus allowing for the most effective HFNC performance. [ABSTRACT FROM AUTHOR]

High-flow nasal cannula (HFNC) is becoming the gold standard to treat respiratory distress at any age since it potentially provides several significant clinical advantages. An obstacle to the diffusion of this simple and effective system of oxygen therapy is the impossibility to know the optimal flow rate leading to such advantages that allows the reduction in the respiratory effort without causing hyperinflation. To assist clinicians during HFNC treatment in setting the optimal flow rate and in determining the most relevant parameters related to respiratory mechanics and the effort of the patient, we developed a new programmable data monitoring, acquisition, and elaborating system (Pro_HFNC). The application of Pro_HFNC is fully compatible with HFNC as it is interfaced with patient through a facial mask and two specific catheters. The unavoidable and unpredictable loss of air flow occurring around the contour of the mask is evaluated and compensated by a specific algorithm implemented by Pro_HFNC. Our preliminary clinical trials on pediatric patients treated with HFNC show that Pro_HFNC is actually capable to detect for any specific patient both the lower threshold of the delivered flow beyond which the benefits of HFNC application are reached and all the parameters useful for a complete evaluation of the respiratory profile. Pro_HFNC can really help physicians in setting the optimal flow rate during HFNC treatment, thus allowing for the most effective HFNC performance.

Studies of flow through the human airway have shown that inhalation time (IT) and secondary flow structures can play important roles in particle deposition. However, the effects of varying IT in conjunction with the respiratory rate (RR) on airway flow remain unknown. Using three-dimensional numerical simulations of oscillatory flow through an idealized airway model (consisting of a mouth, glottis, trachea, and symmetric double bifurcation) at a trachea Reynolds number (Re) of 4200, we investigated how varying the ratio of IT to breathing time (BT) from 25% to 50% and RR from 10 breaths per minute (bpm) corresponding to a Womersley number (Wo) of 2.41 to 1000 bpm (Wo = 24.1) impacts airway flow characteristics. Irrespective of IT/BT, axial flow during inhalation at tracheal cross-sections was non-uniform for Wo = 2.41, as compared to centrally concentrated distribution for Wo = 24.1. For a given Wo and IT/BT, both axial and secondary (lateral) flow components unevenly split between left and right branches of a bifurcation. Irrespective of Wo, IT/BT and airway generation, lateral dispersion was a stronger transport mechanism than axial flow streaming. Discrepancy in the oscillatory flow relation Re/Wo2 = 2 L/D (L = stroke length; D = trachea diameter) was observed for IT/BT ≠ 50%, as L changed with IT/BT. We developed a modified dimensionless stroke length term including IT/BT. While viscous forces and convective acceleration were dominant for lower Wo, unsteady acceleration was dominant for higher Wo.