Enteral Feedings May Improve Outcomes Among Patients Treated With HHFNO Therapy

Background: Heated high-flow nasal oxygen (HHFNO) therapy has become commonly and effectively used in the treatment of hypoxemic respiratory failure. HHFNO delivers oxygen at flow rates of up to 60 L/min and thereby generates positive airway pressure. Other forms of noninvasive positive pressure ventilation (NIPPV) may be poorly tolerated with airway compromise; therefore, patients receiving NIPPV are usually held nil per os (NPO or nothing by mouth) or nearly so. The situation is less clear among patients receiving HHFNO therapy, as it is known to worsen esophageal reflux and inhibit swallowing function in some patients. Objective: To assess the risks of aspiration and progressive respiratory failure among patients receiving HHFNO therapy. Design: Single-center, retrospective cohort study. Methods: 220 patients receiving HHFNO therapy between 2020 and 2022 were included. Patients receiving total parenteral nutrition, had “do not intubate” code status, had tracheostomy, o more...