2017 Volume 34 Issue 2 Pages 117-120
High–flow nasal cannula (HFNC) oxygen therapy is a method of respiratory care using a novel oxygen–supplying device. This therapy is rapidly becoming widespread due to the high efficacy of oxygenation and preservation of patient quality of life. An 87–year–old woman developed CO2 narcosis from aspiration pneumonia and atelectasis 2 days after lateral medullary infarction. Because the family did not want tracheal intubation, and because non–invasive positive pressure ventilation (NPPV) was withheld due to the requirement for frequent suction, the patient was treated with HFNC oxygen therapy. Arterial blood gas analysis revealed improvement of hypercapnia 1h after applying HFNC oxygen therapy. The patient recovered consciousness after 6h of HFNC oxygen therapy. HFNC was switched to routine oxygenation after a week. No progression of medullary infarction was detected during the course, and the patient was transferred to a rehabilitation facility. HFNC oxygen therapy has advantages in bronchial drainage, although tracheal intubation or NPPV should first be applied for respiratory failure with hypercapnia. HFNC oxygen therapy represents a useful option for clinicians with sufficient knowledge about its merits and demerits, when mechanical ventilation must be withheld considering the background of the patient.
