Accession Number : ADA627618


Title :   Use of a High-Flow Oxygen Delivery System in a Critically Ill Patient with Dementia


Descriptive Note : Journal article


Corporate Author : ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX


Personal Author(s) : Calvano, Tatjana P ; Sill, Joshua M ; Kemp, Kenneth R ; Chung, Kevin K


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a627618.pdf


Report Date : 01 Dec 2008


Pagination or Media Count : 6


Abstract : We used a high-flow nasal cannula with a patient who required a high fraction of inspired oxygen but could not tolerate a nasal or facial mask. We saw a 92-year-old woman with delirium and dementia in the intensive care unit for multi-lobar pneumonia with severe hypoxemia. Attempts to oxygenate the patient failed because she was unable to tolerate various facial and nasal masks. We then tried a high-flow nasal cannula (Vapotherm 2000i), which she tolerated well, and she had marked improvement in gas exchange and quality of life. The patient had severe health-care- associated pneumonia, accompanied by delirium and hypoxemia. It became apparent that the patient s death was imminent, and the goal of therapy was palliative. She had previously clearly expressed a desire not to undergo intubation and mechanical ventilation. In a situation where the patient was agitated and unable to tolerate a mask, the high-flow cannula reduced her agitation and improved her dyspnea, oxygenation, tolerance of oxygen therapy, and comfort at the end of life. Oxygen via high-flow cannula may enhance quality of life by reducing hypoxemia in patients who are unable to tolerate a mask but need high oxygen concentration.


Descriptors :   *GAS EXCHANGE(BIOLOGY) , *HYPOXIA , *OXYGEN EQUIPMENT , *PNEUMONIA , *VENTILATION , ANTIBIOTICS , BLOOD GASES , BREATHING GASES , BREATHING MASKS , CASE STUDIES , CLINICAL MEDICINE , COGNITIVE IMPAIRMENT , FACE(ANATOMY) , INTENSIVE CARE UNITS , INTUBATION , MONITORING , PATIENTS , RESPIRATION , TACHYCARDIA , TOLERANCES(PHYSIOLOGY)


Subject Categories : Anatomy and Physiology
      Medicine and Medical Research
      Medical Facilities, Equipment and Supplies


Distribution Statement : APPROVED FOR PUBLIC RELEASE