Modern Approach to the Treatment of Acute Respiratory Failure – from nasal cannula to ECMO

Abstract

Introduction

Respiratory failure is a major healthcare issue, significantly threatening patient life. Early diagnosis and appropriate oxygen therapy are critical for improving prognosis. This article aims to summarize and compare current oxygen therapy methods and their clinical indications.

Material and Methods

Oxygen therapy methods were discussed in the context of acute respiratory failure in the emergency department. The therapies reviewed included conventional oxygen therapy (COT), high-flow nasal oxygen therapy (HFNOT), noninvasive ventilation (NIV), invasive ventilation, and extracorporeal membrane oxygenation (ECMO). Indications were based on the latest guidelines from the European Respiratory Society, American Thoracic Society, and other medical organizations.

Results

High-flow nasal oxygen therapy (HFNOT) is superior to conventional oxygen therapy in treating acute hypoxemic respiratory failure, reducing the need for therapy escalation. Noninvasive ventilation (NIV) is effective for patients with respiratory acidosis and COPD exacerbations. ECMO is a life-saving option when other treatments fail, but its use is limited to patients with reversible causes of respiratory failure.

Conclusions

The choice of oxygen therapy depends on the patient's clinical condition. Modern approaches, such as HFNOT and NIV, offer advantages in reducing mortality and the need for invasive ventilation in acute respiratory failure, compared to traditional therapies. ECMO remains effective in severe cases but is reserved for specific indications. Further research is needed to optimize oxygen therapy use, focusing on reducing mortality and complications.