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Editorial
Pulmonary
Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
SeungYong Park
Acute Crit Care. 2021;36(4):388-389.   Published online November 30, 2021
DOI: https://doi.org/10.4266/acc.2021.01641
  • 9,048 View
  • 75 Download
  • 1 Web of Science
  • 1 Crossref
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Citations to this article as recorded by  
  • Comparison of clinical characteristics and hospital mortality in critically ill patients without COVID-19 before and during the COVID-19 pandemic: a multicenter, retrospective, propensity score-matched study
    Sua Kim, Hangseok Choi, Jae Kyeom Sim, Won Jai Jung, Young Seok Lee, Je Hyeong Kim
    Annals of Intensive Care.2022;[Epub]     CrossRef
Review Article
Pulmonary
High-flow nasal cannula for respiratory failure in adult patients
SeungYong Park
Acute Crit Care. 2021;36(4):275-285.   Published online November 30, 2021
DOI: https://doi.org/10.4266/acc.2021.01571
  • 65,535 View
  • 1,885 Download
  • 34 Web of Science
  • 37 Crossref
AbstractAbstract PDF
The high-flow nasal cannula (HFNC) has been recently used in several clinical settings for oxygenation in adults. In particular, the advantages of HFNC compared with low-flow oxygen systems or non-invasive ventilation include enhanced comfort, increased humidification of secretions to facilitate expectoration, washout of nasopharyngeal dead space to improve the efficiency of ventilation, provision of a small positive end-inspiratory pressure effect, and fixed and rapid delivery of an accurate fraction of inspired oxygen (FiO2) by minimizing the entrainment of room air. HFNC has been successfully used in critically ill patients with several conditions, such as hypoxemic respiratory failure, hypercapneic respiratory failure (exacerbation of chronic obstructive lung disease), post-extubation respiratory failure, pre-intubation oxygenation, and others. However, the indications are not absolute, and much of the proven benefit remains subjective and physiologic. This review discusses the practical application and clinical uses of HFNC in adults, including its unique respiratory physiologic effects, device settings, and clinical indications.

Citations

Citations to this article as recorded by  
  • Prediction of high-flow nasal cannula failure in critically ill patients: a narrative review
    Yaxiaerjiang Muhetaer, Shi-min Zhang, Amanguli Moming, Kai Liu, Ming Zhong
    Journal of Intensive Care.2026;[Epub]     CrossRef
  • Heated and Humidified Oxygen in Critical Care Transport: Evaluating the Use of Aerogen Pro-X Nebulizer as an Alternative to Traditional High-Flow Humidifiers
    Maria Karas, Trace Choulat, Jamie Persten, Conner Rucks, Ravi Panchigar, Emma Beqaj, Emily Puckett, Andrew Joseph, Derek Hunt
    Air Medical Journal.2026;[Epub]     CrossRef
  • The effect of high-flow nasal cannula oxygen therapy on preventing hypoxemia during deep sedation extubation after laparoscopic surgery: a prospective randomized controlled trial
    Yi-Kai Wang, Xiang Li, Shi-You Wei, Hui Yang, Zhou-Peng Tan, Sheng-Ming Yan, Wei Liu, Xin Lv
    BMC Anesthesiology.2026;[Epub]     CrossRef
  • Adherence and influencing factors of high-flow nasal cannula humidified oxygen therapy in elderly patients with stable chronic obstructive pulmonary disease: A meta-analysis
    Yang Yang, Ting-Ting Liu, Dong-Mei Li, Xue-Ling Ren, Zheng Luo, Xue-Li Chen, Ying-Zhen Du, Yan-Shuang Cheng
    Annals of Thoracic Medicine.2025; 20(1): 49.     CrossRef
  • Comparison of high flow nasal cannula and conventional oxygen therapy post-extubation in intensive care unit: A prospective crossover observational study
    Govindraj M Bhat, Anil R Shetty, Gouri Pratyusha Kintamani
    Indian Journal of Clinical Anaesthesia.2025; 12(1): 125.     CrossRef
  • Impact of the Early Use of High-flow Nasal Cannula in Patients with Post-traumatic Lung Contusion: A Randomized Clinical Trial
    Rania G Elsayed, Amr F Hafez, Mohammed M Maarouf, Farouk KE AbdElAziz
    Indian Journal of Critical Care Medicine.2025; 29(2): 117.     CrossRef
  • Comparison of high-flow nasal oxygen therapy and noninvasive ventilation in suspected sepsis patients with acute respiratory distress in the emergency department: a retrospective cohort study
    Chuenruthai Angkoontassaneeyarat, Prapimporn Charoenphon, Pitsucha Sanguanwit, Chaiyaporn Yuksen, Suteenun Seesuklom
    International Journal of Emergency Medicine.2025;[Epub]     CrossRef
  • Comparison of Procedural Oxygen Mask and Nasal Cannula in Endoscopic Procedures: A Prospective Observational Study
    Aydogan Celik, Mehmet Yilmaz, Ahmet Yuksek, Sema Candan, Ayse Zeynep Turan Civraz, Merve Yazici Kara, Bedirhan Gunel
    Bratislava Medical Journal.2025; 126(6): 1085.     CrossRef
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    Youjin Chang, Moon Seong Baek, Sei Won Kim, Su Hwan Lee, Jung Soo Kim, So Young Park, Jin Woo Kim, Jae Hwa Cho, Sunghoon Park
    Tuberculosis and Respiratory Diseases.2025; 88(2): 264.     CrossRef
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    Fernanda Cristina Barbosa Lana, Carolina Coimbra Marinho, Bruno Barbosa Miranda de Paiva, Lucas Rocha Valle, Guilherme Fonseca do Nascimento, Leonardo Chaves Dutra da Rocha, Marcelo Carneiro, Joanna d‘Arc Lyra Batista, Fernando Anschau, Pedro Gibson Parai
    BMC Infectious Diseases.2025;[Epub]     CrossRef
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    Xingxing Chen, Kang Gu, Yunqing Yang, Bingbing Zhou, Yunchang Mo, Yingying Tu
    Journal of Multidisciplinary Healthcare.2025; Volume 18: 2651.     CrossRef
  • Implementation of High-Flow Oxygen Therapy in a Surgical High-Dependency Unit: A Cohort Study
    Joanne Chong Hui Ling , Bridget Ng Si Min, Shi Min Tan, Wei Qin Teo, Irene Too Ai Ling, Jolin Wong, Vui K Ho, Shin Yi Ng, Aarthi Suhitharan, Suhitharan Thangavelautham
    Cureus.2025;[Epub]     CrossRef
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    Won Jin Yang, Yong Jun Choi, Kyung Soo Chung, Ji Soo Choi, Bo Mi Jung, Jae Hwa Cho
    Acute and Critical Care.2025; 40(2): 171.     CrossRef
  • Breathing Easy
    Stephanie Gregory, Sandra Waugaman, Sarah Zeller
    Critical Care Nursing Clinics of North America.2025; 37(3): 461.     CrossRef
  • Factors affecting critical care outcomes in the emergency department
    Taylor M. Fontenot, Ioana Antonescu, Heatherlee Bailey
    Current Opinion in Critical Care.2025; 31(5): 566.     CrossRef
  • Comparison of three different flow rates of oxygen with high-flow nasal cannula versus conventional nasal oxygen therapy in adult patients undergoing endoscopic retrograde cholangiopancreatography
    Arundhati Chadha, Anil Yogendra Yadav, Udit Dhingra, Gaurav Sindwani, Vinod Arora, Deepak K. Tempe
    Trends in Anaesthesia and Critical Care.2025; 65: 101600.     CrossRef
  • Practice of High-Flow Nasal Cannula in Patients with Mild to Moderate COPD Among Healthcare Providers in Saudi Arabia: A Cross-Sectional Study
    Abdulelah Aldhahir, Mohammed Alyami, Osama Alanazi, Ahmed Alasimi, Abdullah Alqarni, Jaber Alqahtani, Abdallah Naser, Hassan Alwafi, Mohammad Dairi, Saeed Alghamdi, Rayan Siraj, Nowaf Alobaidi, Mohammed Almeshari, Abdulrhman Alghamdi
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    Critical Care.2025;[Epub]     CrossRef
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    Medicine.2025; 104(48): e45782.     CrossRef
  • Physical and Physiological Mechanisms of Emergent Hydrodynamic Pressure in High-Flow Nasal Cannula Therapy
    Jose Luis Estela-Zape
    Advances in Respiratory Medicine.2025; 94(1): 1.     CrossRef
  • Asymmetrical high-flow nasal cannula performs similarly to standard interface in patients with acute hypoxemic post-extubation respiratory failure: a pilot study
    Annalisa Boscolo, Tommaso Pettenuzzo, Francesco Zarantonello, Nicolò Sella, Elisa Pistollato, Alessandro De Cassai, Sabrina Congedi, Irene Paiusco, Giacomo Bertoldo, Silvia Crociani, Francesca Toma, Giulia Mormando, Giulia Lorenzoni, Dario Gregori, Paolo
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
  • Recommendations from The Medical Education Editor
    Mark Lavercombe
    Respirology.2024; 29(4): 266.     CrossRef
  • Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
    Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
    Acute and Critical Care.2024; 39(1): 1.     CrossRef
  • Clinical Practice of High-Flow Nasal Cannula Therapy in ARDS Patients: A Cross-Sectional Survey of Respiratory Therapists
    Mohammed Alyami, Abdulelah Aldhahir, Abdullah Alqarni, Khalid Salwi, Abdullah Sarhan, Mohammed Almeshari, Nowaf Alobaidi, Jaber Alqahtani, Rayan Siraj, Abdullah Alsulayyim, Saeed Alghamdi, Ahmed Alasimi, Omar Alqarni, Mansour Majrshi, Hassan Alwafi
    Journal of Multidisciplinary Healthcare.2024; Volume 17: 1401.     CrossRef
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    Pingyou He, Xiang Bao, FengFeng Jiang, Xiaobo Liu, Wei Xu, Danfeng Yu, Lin Chen, Feng Chen
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    Shubham Petkar, Dnyanshree Wanjari, Vishnu Priya
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    Irfan Zubair Shahul Hameed, Darpanarayan Hazra, Priya Ganesan, Abhilash Kundavaram Paul Prabhakar
    Turkish Journal of Emergency Medicine.2024; 24(1): 33.     CrossRef
  • Liberation from Mechanical Ventilation in Critically Ill Patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
    Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
    Tuberculosis and Respiratory Diseases.2024; 87(4): 415.     CrossRef
  • High-Flow and Low-Flow Oxygen Delivery by Nasal Cannula Evaluated in Infant and Adult Airway Replicas
    Mozhgan Sabz, Michelle L Noga, Warren H Finlay, Hossein Rouhani, Andrew R Martin
    Respiratory Care.2024; 69(4): 438.     CrossRef
  • Recomendaciones de terapia de alto flujo nasal en el servicio de Urgencias PARTE 1
    Saúl Trejo-Rosas, Ignacio Alberto Mendez-Jesus, Elizabeth Mendoza-Portillo, David Sanabría-Cordero, Miguel Russi-Hernández
    Archivos de Medicina de Urgencia de México.2024; 16(3): 210.     CrossRef
  • The Impact of High-Flow Nasal Cannula Therapy on Acute Respiratory Distress Syndrome Patients: A Systematic Review
    Ahmed M Abdelbaky, Wael G Elmasry , Ahmed H. Awad, Sarrosh Khan, Maryam Jarrahi
    Cureus.2023;[Epub]     CrossRef
  • High-Flow Oxygen Therapy in the Perioperative Setting and Procedural Sedation: A Review of Current Evidence
    Lou’i Al-Husinat, Basil Jouryyeh, Ahlam Rawashdeh, Abdelrahman Alenaizat, Mohammad Abushehab, Mohammad Wasfi Amir, Zaid Al Modanat, Denise Battaglini, Gilda Cinnella
    Journal of Clinical Medicine.2023; 12(20): 6685.     CrossRef
  • Current status of treatment of acute respiratory failure in Korea
    Yong Jun Choi, Jae Hwa Cho
    Journal of the Korean Medical Association.2022; 65(3): 124.     CrossRef
  • Transnasal High-Flow Oxygen Therapy versus Noninvasive Positive Pressure Ventilation in the Treatment of COPD with Type II Respiratory Failure: A Meta-Analysis
    Wei Liu, Mingli Zhu, Liuqin Xia, Xiangying Yang, Pei Huang, Yanming Sun, Ye Shen, Jianping Ma, Gang Chen
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Association between timing of intubation and mortality in patients with idiopathic pulmonary fibrosis
    Eunhye Bae, Jimyung Park, Sun Mi Choi, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
    Acute and Critical Care.2022; 37(4): 561.     CrossRef
  • Effect of high-flow oxygen versus T-piece ventilation strategies during spontaneous breathing trials on weaning failure among patients receiving mechanical ventilation: a randomized controlled trial
    Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee
    Critical Care.2022;[Epub]     CrossRef
Original Article
Liver
Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study
Seon Woo Yoo, Min-Jong Ki, Dal Kim, Seul Ki Kim, SeungYong Park, Hyo Jin Han, Heung Bum Lee
Acute Crit Care. 2021;36(4):322-331.   Published online November 16, 2021
DOI: https://doi.org/10.4266/acc.2021.00276
  • 7,480 View
  • 113 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
The molecular adsorbent recirculating system (MARS) is a hepatic replacement system that supports excretory liver function in patients with liver failure. However, since MARS has been employed in our hospital, bleeding complications have occurred in many patients during or after MARS. The objective of this study was to determine how MARS affects coagulopathy and identify specific factors associated with bleeding complications.
Methods
We retrospectively analyzed data from 17 patients undergoing a total of 41 MARS sessions. Complete blood count, coagulation profiles, and blood chemistry values were compared before and after MARS. To identify pre-MARS factors associated with increased bleeding after MARS, we divided patients into bleeder and non-bleeder groups and compared their pre-MARS laboratory values.
Results
MARS significantly reduced bilirubin and creatinine levels. MARS also increased prothrombin time and reduced platelet and fibrinogen, thus negatively impacting coagulation. Pre-MARS hemoglobin was significantly lower in the bleeder group than in the non-bleeder group (P=0.015). When comparing the upper and lower 33% of MARS sessions based on the hemoglobin reduction rate, hemoglobin reduction was significantly greater in MARS sessions involving patients with low pre-MARS international normalized ratio of prothrombin time (PT-INR) and factor V (P=0.038 and P=0.023, respectively).
Conclusions
MARS could appears to alter coagulation-related factors such as factor V and increase the risk of bleeding complications particularly in patient with low hemoglobin. However, individual differences among patients were large, and various factors, such as low hemoglobin, PT-INR, and factor V levels, appear to be involved.

Citations

Citations to this article as recorded by  
  • Fractionated plasma separation and adsorption integrated with continuous veno‐venous hemofiltration in patients with acute liver failure: A single center experience from China
    Jianhua Dong, Li Huang, Chuan Li, Bian Wu, Xi Yang, Yongchun Ge
    Journal of Clinical Apheresis.2024;[Epub]     CrossRef
  • Crosslinked Bifunctional Particles for the Removal of Bilirubin in Hyperbilirubinemia Cases
    María del Prado Garrido, Ana Maria Borreguero, Maria Jesús Ramos, Manuel Carmona, Francisco Javier Redondo Calvo, Juan Francisco Rodriguez
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  • The Effect of Molecular Adsorbent Recirculating System in Patients With Liver Failure: A Case Series of 44 Patients
    Shahin Isha, Anna S. Jenkins, Abby J. Hanson, Parthkumar H. Satashia, Sai Abhishek Narra, Gunjan D. Mundhra, Mohammed Mustafa Hasan, Ashrita Donepudi, Abishek Giri, Patrick W. Johnson, Dolores Villar, Christan Santos, Juan Canabal, Philip Lowman, Pablo Mo
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    Maria-Jimena Muciño-Bermejo
    Frontiers in Nephrology.2022;[Epub]     CrossRef

ACC : Acute and Critical Care
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