title: Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department.
abstract: OBJECTIVE
  The aim of the study was to determine if oxygen delivered through humidified high flow nasal cannulae (HHFNC) reduced the need for escalation in ventilation management and work of breathing in the ED patients presenting with acute undifferentiated shortness of breath compared with standard oxygen therapy.
  
  
  METHODS
  This was an unblinded randomised control trial conducted at two hospital EDs in Sydney, Australia. Eligible patients presenting with shortness of breath were randomised to HHFNC or standard oxygen therapy. Primary outcomes were the need to escalate ventilation therapy or a reduction in respiratory rate of 20% or more within 2 h of commencement.
  
  
  RESULTS
  One hundred patients were enrolled in the trial. The intervention group receiving HHFNC was associated with a higher proportion of patients with a reduced respiratory rate at 2 h (66.7% vs 38.5%, P = 0.005) and a lower proportion of patients requiring escalation in ventilation therapy (4.2% vs 19%, P = 0.02) compared with standard oxygen therapy.
  
  
  CONCLUSIONS
  The use of high flow nasal cannula oxygenation was associated with improved respiratory state in selected patients presenting to the ED with acute undifferentiated shortness of breath.
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Nerida
authors.initials: N
authors.lastname: Bell
authors.affiliation: Emergency Department, Canterbury Hospital, Sydney, New South Wales, Australia.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Hutchinson
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.|Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Green
authors.affiliation: Emergency Department, Canterbury Hospital, Sydney, New South Wales, Australia.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rogan
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bein
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.|Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dinh
keywords: emergency department; oxygen; shortness of breath