Are home high-flow therapy (HFT) devices as good as hospital HFT devices?

Abstract

Introduction: HFT is widely used in hospitals, but HFT is now also used for the management of chronic respiratory failure. Dedicated blower based HFT devices have been developed for home use. We aimed to assess if home HFT devices achieved similar performances as compared to flow-based hospital devices.

Methods: We evaluated 4 HFT devices designed for home use: Airvo2 (Fisher & Paykel), Eove-150 (Air Liquid Medical System), Prisma Vent-50C (Löwenstein Medical), Lumis HFT (Resmed). Their performances were compared to the Optiflow system (Fisher & Paykel). All devices were tested on a bench model with a 3D-printed head and an artificial lung (ASL 5000, Ingmar Medical). Devices were tested at 30L/min and at 2 levels of temperature without any oxygen. Measurements included: relative humidity (RH) and absolute humidity (AH) after 30 min, positive-end-expiratory pressure (PEEP) generated, work of breathing (WOB), tidal volume (Vt) performed by the simulated patient, inspiratory and expiratory resistances (IR and ER) in the 3D-printed head.

Results: All systems achieved a RH greater than 90% and AH greater than 25 mgH₂O/L, with no significant difference between home and hospital devices (p=0.68 and p=0.12, respectively). PEEP was lower with home devices (3.56 [2.85; 5.08] vs 5.74 [5.38; 6.15] cmH₂O, p=0.02) with an inter-variability among the manufacturers. The total WOB showed no difference. The IR and ER were greater with the hospital system (p<0.01), resulting in diminished Vt (-87ml, p<0.01). ER was strongly correlated with the generated PEEP (rho=0.79, p<0.001).

Conclusion: Home HFT devices delivered a lower level of PEEP as compared to hospital system but had similar performances regarding hygrometry and WOB.