Physiological Basis and Clinical Applications in Anesthesia of High-Flow Nasal Cannula OxygenTherapy

Corresponding author: LI Jin, 1501535247@qq.com628

DOI: 10.12201/bmr.202603.00111

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  Abstract: High-flow nasal cannula (HFNC) therapy represents a non-invasive form of respiratory support, garnering increased interest for its benefits in perioperative management. This review delineates the fundamental components and principal physiological mechanisms of HFNC, encompassing apneic oxygenation, positive end-expiratory pressure (PEEP), anatomical dead space reduction, augmentation of end-expiratory lung volume, precise oxygen delivery, and active humidification. These mechanisms underpin its utility across various perioperative phases, including tracheal intubation, sedation during endoscopic procedures, upper airway surgery, extubation, and recovery. HFNC has also demonstrated potential in specific patient cohorts, such as individuals with obesity, pregnant patients, and the pediatric population. While its clinical advantages and safety profile are well-established, further investigation is warranted to clarify its indications, refine device settings, and examine its integration with complementary respiratory support strategies. This review aims to consolidate current clinical applications and recent advances of HFNC within anesthetic practice, offering a theoretical framework and practical guidance for its standardized implementation.

  Key words: High-flow nasal cannula; Physiological rationale; Perioperative care; Special patient groups; Anesthesia practice

  Submit time: 25 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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