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OPTIFLOW (BENEFITS (INCREASED MUCOSAL CLEARANCE (REFERAL TO THE PHYSIO…
OPTIFLOW
BENEFITS
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OPTIFLOW V NIV P VALUE 0.0006 IN FLORRALI STUDY RESULTS ARE SIGNIFICNAT BUT CONDUCTED IN FRANCE AND BELGIUM
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DATA
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HFNC V NIV ALSO IN ITU, PRE OP, POST INTUBATION
1 STUDY INCLUDED IPF 3 CASE STUDY REVIEWS. EACH OF THESE PATIENTS ALSO RECIEVED STERIOD AND PHARMACOLOGICAL SUPPORT ALONGSIDE THE HFNC
STUDIES IDENTIFY PEEP BUT THIS DOES DEPEND ON OTHER FACTORS AND WERE THESE TAKEN INTO ACCOUNT. SEX, BODY MASS, MOUTH OPEN OR CLOSED AND FLOW.
DUE TO THE DATA BEING TAKEN FORM A SPECTRUM OF CRITICALLY ILL PATIENT POPULATIONS LEADS TO GENERALISING THE EFFICACY OF THE USE OF HFNC
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FURTHER STUDY NEEDED
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FURTHER EXPLORATIO OF WHEN TO START AND STOP OPTIFLOW. ALSO WEHN DOES IT BECOME A PALLIATIVE MEASURE.
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LIMITATIONS
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CREATION OF PEEP DEPENDANT OF A NUMBER OF FACTORS, SEX BODY MASS, MOUTH OPEN CLOSED AND THE FLOW. VARGARS ET AL
ABILITY TO CONDUCT BLIND RANDOMISED TRIALS WITH OXYGEN IS DIFFICULT THE
ethics committees were unwilling to deprive patients of this potentially useful treatment
their use is limited by ethical and practical concerns. Exposing patients to an intervention believed to be inferior to current treatment is often thought unethical
DNAR
PETERS ET AL NOTED THAT 82%V OF PATIENTS WITH DNAR HFNC PROVIDED ADEQUATE OXYGENATIO WITHOUT THE NEED FOR NIV
MDT INVOLVEMENT
PHYSIO, OUTREACH, RESPIRATORY SPECIALIST NURSE