Скачать или смотреть High Flow Nasal Oxygen/Cannula in Hypoxemic Respiratory Failure (FLORALI): One-Minute Journal Club

The FLORALI trial was the landmark clinical trial that put the utilization of nasal high flow (HFNC, NHF, HFNO, HFO, etc.) on the map. Here, I quickly break down the trial and why it is important.

Show Notes: https://eddyjoemd.com/florali/

Script:
Ever wonder how high flow nasal oxygen became so prevalent?
In 2015, the FLORALI trial was published in the New England Journal of Medicine
This is not medical advice, read the article for yourself.
The took over 300 patients who were in acute hypoxemic respiratory failure.
The majority had pneumonia/ARDS.
They were randomized to either a non-rebreathers, non-invasive ventilation, or high-flow.
The primary outcome was intubation at 28 days.
There was no difference.
So you ask, why is this so important if there's no difference?
Well, in a subgroup analysis, they found that in the sicker patients, those with a PF ratio of 200 or less, high flow decreased the risk of intubation.
High flow also decreased the risk of ICU mortality and 90 day mortality.
Sure, the NIV group was targeted to receive 7-10cc per kg of ideal body weight .
Not to mention, which device would you rather have on your face?

Citation:
Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, Prat G, Boulain T, Morawiec E, Cottereau A, Devaquet J, Nseir S, Razazi K, Mira JP, Argaud L, Chakarian JC, Ricard JD, Wittebole X, Chevalier S, Herbland A, Fartoukh M, Constantin JM, Tonnelier JM, Pierrot M, Mathonnet A, Béduneau G, Delétage-Métreau C, Richard JC, Brochard L, Robert R; FLORALI Study Group; REVA Network. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015 Jun 4;372(23):2185-96. doi: 10.1056/NEJMoa1503326. Epub 2015 May 17. PMID: 25981908.