Current practice and barriers to using high‐flow nasal cannula among ARDS patients in Saudi Arabia: a cross‐sectional study of physicians
Author(s)
Type
Journal Article
Abstract
Background and Aims
High-flow nasal cannula (HFNC) is increasingly utilized in clinical practice; however, the perspectives of physicians on its use and associated barriers in managing acute respiratory distress syndrome (ARDS) in Saudi Arabia remain unexplored. This study aims to evaluate HFNC practices and identify the barriers faced by ICU and respiratory physicians in utilizing HFNC for ARDS patients.
Methods
A cross-sectional survey was distributed between December 22, 2022, and July 15, 2023, to respiratory and ICU physicians in Saudi Arabia. Data are presented as frequencies and percentages.
Results
A total of 987 responses were analyzed, revealing that physicians perceive HFNC as beneficial for relieving shortness of breath (686, or 69.5%), helping with speech and eating (649, or 65.8%), and potentially preventing intubation (629, or 63.7%). In terms of HFNC practice, 445 respondents (45.1%) reported that its use is governed by institutional protocols, while 679 (68.8%) indicated that the decision to initiate therapy is made by physicians. Additionally, 458 (46.4%) stated that a flow rate of ≥ 15 L/min is necessary to start HFNC therapy. When considering initial settings, nearly half (455, or 46.09%) chose a fraction of inspired oxygen (FiO2) between 61%–80%, 442 (44.8%) chose a flow between 30 and 40 L/min, and 476 (48.23%) chose a temperature of 34°C. Reducing gas flow by 5–10 L/min every two to 4 h was the most appropriate way of weaning, according to 407 (41.24%), and both FiO2 < 35% and gas flow < 20 L/min should be achieved to disconnect HFNC therapy. Lack of knowledge about HFNC therapy was the most commonly reported barrier (494, or 50.1%).
Conclusion
Physicians demonstrated a comprehensive understanding of the potential benefits associated with HFNC therapy. However, variations in initial settings and the absence of standardized guidelines present significant challenges to its optimal application in patients with ARDS.
High-flow nasal cannula (HFNC) is increasingly utilized in clinical practice; however, the perspectives of physicians on its use and associated barriers in managing acute respiratory distress syndrome (ARDS) in Saudi Arabia remain unexplored. This study aims to evaluate HFNC practices and identify the barriers faced by ICU and respiratory physicians in utilizing HFNC for ARDS patients.
Methods
A cross-sectional survey was distributed between December 22, 2022, and July 15, 2023, to respiratory and ICU physicians in Saudi Arabia. Data are presented as frequencies and percentages.
Results
A total of 987 responses were analyzed, revealing that physicians perceive HFNC as beneficial for relieving shortness of breath (686, or 69.5%), helping with speech and eating (649, or 65.8%), and potentially preventing intubation (629, or 63.7%). In terms of HFNC practice, 445 respondents (45.1%) reported that its use is governed by institutional protocols, while 679 (68.8%) indicated that the decision to initiate therapy is made by physicians. Additionally, 458 (46.4%) stated that a flow rate of ≥ 15 L/min is necessary to start HFNC therapy. When considering initial settings, nearly half (455, or 46.09%) chose a fraction of inspired oxygen (FiO2) between 61%–80%, 442 (44.8%) chose a flow between 30 and 40 L/min, and 476 (48.23%) chose a temperature of 34°C. Reducing gas flow by 5–10 L/min every two to 4 h was the most appropriate way of weaning, according to 407 (41.24%), and both FiO2 < 35% and gas flow < 20 L/min should be achieved to disconnect HFNC therapy. Lack of knowledge about HFNC therapy was the most commonly reported barrier (494, or 50.1%).
Conclusion
Physicians demonstrated a comprehensive understanding of the potential benefits associated with HFNC therapy. However, variations in initial settings and the absence of standardized guidelines present significant challenges to its optimal application in patients with ARDS.
Date Issued
2025-09-01
Date Acceptance
2025-07-17
Citation
Health Science Reports, 2025, 8 (9)
ISSN
2398-8835
Publisher
Wiley
Journal / Book Title
Health Science Reports
Volume
8
Issue
9
Copyright Statement
© 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
License URL
Publication Status
Published
Article Number
e71181
Date Publish Online
2025-09-18