International survey of high-flow nasal therapy use for respiratory failure in adult patients

Asem Alnajada, Bronagh Blackwood, Ben Messer, Ivan Pavlov, Murali Shyamsundar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Downloads (Pure)


(1) Background: High-flow nasal therapy (HFNT) has shown several benefits in addressing respiratory failure. However, the quality of evidence and the guidance for safe practice are lacking. This survey aimed to understand HFNT practice and the needs of the clinical community to support safe practice. (2) Method: A survey questionnaire was developed and distributed to relevant healthcare professionals through national networks in the UK, USA and Canada; responses were collected between October 2020 and April 2021. (3) Results: In the UK and Canada, HFNT was used in 95% of hospitals, with the highest use being in the emergency department. HNFT was widely used outside of a critical care setting. HFNT was mostly used to treat acute type 1 respiratory failure (98%), followed by acute type 2 respiratory failure and chronic respiratory failure. Guideline development was felt to be important (96%) and urgent (81%). Auditing of practice was lacking in 71% of hospitals. In the USA, HFNT was broadly similar to UK and Canadian practice. (4) Conclusions: The survey results reveal several key points: (a) HFNT is used in clinical conditions with limited evidence; (b) there is a lack of auditing; (c) it is used in wards that may not have the appropriate skill mix; and (d) there is a lack of guidance for HFNT use.

Original languageEnglish
Article number3911
Number of pages13
JournalJournal of Clinical Medicine
Issue number12
Publication statusPublished - 08 Jun 2023


  • acute hypercapnic respiratory failure
  • acute hypoxemic respiratory failure
  • acute settings
  • chronic respiratory failure
  • chronic settings
  • high-flow nasal cannula


Dive into the research topics of 'International survey of high-flow nasal therapy use for respiratory failure in adult patients'. Together they form a unique fingerprint.

Cite this