Evidence mapPaperPMID 41849489Full record

Observational studyCritical care science2026

Patterns and outcomes of real-world high-flow nasal cannula use: a multi-hospital retrospective cohort study.

Diana C Bouhassira, Chad H Hochberg, Sarina K Sahetya, Ann Parker, Khyzer B Aziz, Li Yan, Theodore John Iwashyna

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Critical care science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Diana C BouhassiraDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0009-0002-5061-8530
Chad H HochbergDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0000-0002-4376-5754
Sarina K SahetyaDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0000-0003-2127-3609
Ann ParkerDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0000-0002-0293-0549
Khyzer B AzizDivision of Neonatology, Department of Pediatrics, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0000-0002-3519-6694
Li YanDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0009-0000-7119-6870
Theodore John IwashynaDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University - Baltimore, Maryland, United States.ORCID http://orcid.org/0000-0002-4226-9310

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo characterize real-world high-flow nasal cannula use and outcomes.

methodsA retrospective observational study using an electronic health record registry of all adult patients in a five-hospital system between 2017 - 2025. We identified all high-flow nasal cannula episodes, defined as periods of high-flow nasal cannula use containing breaks no longer than 6 hours. We describe key measurements, including high-flow nasal cannula episode duration, intubation rates, and death or hospice discharge rates; secondary outcomes included intensive care unit admission, lengths of stay, and discharge location. We used adjusted hierarchical logistic regression to evaluate variation across hospitals.

results28,269 high-flow nasal cannula episodes from 17,519 individual patients over 19,313 hospitalizations were identified. Average high-flow nasal cannula use increased from 176 episodes/month in 2017 to 269 episodes/month by 2024 (p < 0.001). Median episode duration was 13.9 [interquartile range 4.3 - 36] hours, 24.5% of episodes were followed by intubation, and 29.3% by death or hospice discharge; 83.6% of high-flow nasal cannula use was escalation respiratory therapy, with the remainder used within 24 hours of extubation. Illness severity, admitting service, hospital, and unit type were associated with the odds of intubation and the duration of high-flow nasal cannula episodes; 16% of the variation in mortality and 20% of the variation in intubation were attributable to hospital-level variation.

conclusionHigh-flow nasal cannula is used in multiple hospital settings and contexts. The use of high-flow nasal cannula has increased between 2017 and 2025. Outcomes of high-flow nasal cannula use are influenced by both patient characteristics and the contexts in which it is used.

Indexed as

CannulaOxygen Inhalation TherapyAgedFemaleHumansIntensive Care UnitsLength of StayMaleMiddle AgedRetrospective Studies

Identifiers

PMID41849489
PMCPMC13124109

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.