High flow oxygen via nasal cannula: Palliative care and ethical considerations

Rev Mal Respir. 2022 Apr 19:S0761-8425(22)00136-X. doi: 10.1016/j.rmr.2022.02.061. Online ahead of print.ABSTRACTHigh flow oxygen via nasal cannula (HFO2NC) has become the first-line reference symptomatic treatment for hypoxemic acute respiratory failure. This non-invasive technique can be addressed, as palliative therapeutic care, to frail patients near end-of-life with a do-not-intubate order. A distinction will be made between those with an imminent and inevitable fatal outcome (pallitative end-of-life management) and those with hope for transient clinical remission (meliorative management). This review focuses on the expected physiological benefits and technical benefits/risks incurred by HFO2NC use in this population. Its main purpose is to highlight the ethical principles governing the palliative management of patients in acute respiratory failure with a do-not-intubate order, and to discuss the various elements to be considered when defining the patient's palliative care plan, in a holistic, individual-centered approach.PMID:35459588 | DOI:10.1016/j.rmr.2022.02.061
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Authors: Source Type: research