Survey : Use of High-flow Nasal Cannula in Hypercapnic Respiratory Failure (HyFNC)

Dear Colleagues, Non-invasive ventilation (NIV) is part of the initial management of hypercapnic respiratory failure. NIV can be associated with adverse effects including skin damage, limitations with oral access, and interface intolerance which may lead to early termination. High-flow nasal cannula (HFNC) systems deliver highrate humidified oxygen through more tolerable nasal cannula. HFNC can theoretically reduce dead space, reduce inspiratory airway resistance, and augment alveolar recruitment. These physiological benefits help reduce work of breathing while providing oxygen in a carefully controlled manner. Current HFNC guidelines (ERS 2022) suggest a trial of NIV prior to HFNC use in a patient with hypercapnic respiratory failure; however, this is based on low certainty evidence.

Data on the current practice of using HFNC in patients with hypercapnic respiratory failure is lacking. On behalf of the investigators of HyFNC, we invite you to complete an anonymous survey regarding the use of HFNC in hypercapnic respiratory failure.

The objectives of this survey are to identify if HFNC is being used to treat hypercapnic respiratory failure, the types of cases it is being used in, and what clinicians consider treatment failure. This data will be used to help understand the current practice and inform the design of a randomized controlled trial.

The survey is 15 questions and should take approximately 5 minutes to complete.

The survey has been reviewed by the Hamilton Integrated Research Ethics Board under Project #15014. No identifying information will be collected, and all data will be published in aggregate form only. By clicking the link and completing the survey, you are consenting to participate in this voluntary activity. The survey cannot be withdrawn once submitted. Thank you in advance for your participation and support.

If you have any questions regarding the survey, please contact:

Kim Lewis, M.Sc, M.D, FRCPC
McMaster University Clinical Investigator
St Joseph’s Healthcare Hamilton Intensivist

Waleed Alhazzani MD, MSc (epid),DABIM, FRCPC
McMaster University Clinical Investigator
St Joseph’s Healthcare Hamilton Intensivist

Malik Farooqi, MD, FRCPC
McMaster University Clinical Fellow
St Joseph’s Healthcare Hamilton