key: cord-0029607-st4ivsbp
authors: Sharma, Ankur; Vyas, Varuna; Goyal, Shilpa; Kothari, Nikhil
title: Ulcer due to prolonged use of high-flow nasal oxygen
date: 2021-11-27
journal: Braz J Anesthesiol
DOI: 10.1016/j.bjane.2021.11.008
sha: 0d604469020f4738b632fcd186961bf97d3bc8e8
doc_id: 29607
cord_uid: st4ivsbp

nan

publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. The prolonged administration of high-flow nasal oxygen (HFNO) can create friction between the nose and the cannula. This causes trauma to the skin and can lead to the formation of ulcers. Continuing the Coronavirus disease-2019 (COVID-19) pandemic, patients may require prolonged usage of HFNO therapy. It is noninvasive, simple to use (needing a fraction of inspired oxygen [FiO 2 ] and flow setting only), and delivers heated and humidified oxygen. It is also beneficial for patients since people who receive HFNO therapy are awake and can speak, eat, and drink. 1 Generally, it does not have to be interrupted or discontinued as a result of intolerance. But it can also lead to pressure ulcers, if used for a prolonged period (Fig. 1 ). The first patient received HFNO therapy with FiO 2 of 90−100% and 60 liters per minute flow for 11 days. The second patient received HFNO therapy with FiO 2 of 100% and 70 liters per minute flow for nine days. Sterile dressings were applied to the ulcer, and good hygiene was maintained. In the next couple of days, the ulcer showed healing.

It is advised to observe frequently for the occurrence of these ulcers during HFNO therapy. If ulcers develop, one should avoid infection by applying the sterile dressing, maintaining good hygiene, proper caring for wounds, managing discomfort, and ensuring adequate nutrition. 

What every intensivist should know about using high-flow nasal oxygen for critically ill patients. Rev Bras Ter Intensiva

The authors declare no conflicts of interest.