Humidified High-Flow Nasal Oxygen Utilization in Patients with Cancer at Memorial Sloan-Kettering Cancer Center
Publication: Journal of Palliative Medicine
Volume 14, Issue Number 7
Abstract
Background: Respiratory signs and symptoms are commonly encountered by physicians who care for cancer patients. Supplemental oxygen (SOx) has long been used for treatment of hypoxic respiratory insufficiency, but data reveal mixed efficacy results. The use and outcome patterns of technologically advanced oxygen delivery devices, such as humidified high-flow nasal oxygen (HHFNOx), are incompletely understood.
Methods: Institutional database search of the number of patient cases in which the current HHFNOx device was used, and abstraction of 183 patient medical records for usage characteristics.
Results: Patients have been treated with HHFNOx at Memorial Sloan Kettering Cancer Center (MSKCC) since 2008. Of the 183 patients randomly selected for our study, 72% received HHFNOx in the intensive care unit (ICU) because of hypoxia. Patients usually improved (41%) or remained stable (44%) while on the device, whereas 15% declined. At study completion, 45% of patients were living, and 55% had died. The median time on HHFNOx was 3 days (range: 1–27). A do not resuscitate (DNR) order was present in 101 (55%) patients, either before (12%) or after (43%) device utilization. The majority (78%) of these 101 patients died at MSKCC.
Conclusion: Dyspnea is a common and important symptom in cancer patients for which SOx traditionally has had no clear basis except in select cases of hypoxia and patient preference. Our institutional experience with HHFNOx contributes to the understanding of the applications and challenges surrounding the use of new medical devices in the cancer population. Physiologic and quality-of-life benefits of HHFNOx compared with traditional oxygen delivery methods should be studied prospectively.
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Information & Authors
Information
Published In
Journal of Palliative Medicine
Volume 14 • Issue Number 7 • July 2011
Pages: 835 - 839
PubMed: 21599530
Copyright
Copyright 2011, Mary Ann Liebert, Inc.
History
Published in print: July 2011
Published online: 23 June 2011
Published ahead of print: 20 May 2011
Accepted: 22 February 2011
Authors
Author Disclosure Statement
No competing financial interests exist.
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