Exploring the Risks of High-Flow Nasal Cannula Therapy: What You Should Know

Although high-flow nasal cannula (HFNC) therapy has known benefits, it also comes with risks and complications. Based on the scoping review done by Johnny et al, there are 8 risk categories for use of HFNC therapy: deterioration, death, device-related events, delay, disposition, debility, distress, and dysphagia. Deterioration is the most common risk (reported in 86% of studies) and is related to intubation, mechanical ventilation, and secondary infection. Death is the second most commonly studied risk (70%). Device-related events (20%) studied include lung injury, gastrointestinal effects, and pressure injury. Delays (17%) including delayed intubation, duration of HFNC therapy, and delayed referral for palliative care are also risks. Less commonly studied risks include disposition, debility, distress, and dysphagia. Careful consideration of these potential risks associated with HFNC therapy is crucial for clinicians to ensure that the benefits of HFNC therapy outweigh the risks for each patient.