From Discharge to Home - Humidified High Flow Therapy for the Post-Acute Space

Published in Member Communities on November 13, 2023

When discussing challenges for homecare and LTC clinicians, it is a guarantee that chronic airway diseases will be at the forefront of these conversations. Rightfully so, as COPD effects more than fifteen million Americans and causes over eight million ER visits annually. This places a massive strain on the health care system, limits the quality of life of those diagnosed with the disease, and poses serious challenges for the RT’s tasked with managing these patients.  

Considering treatment for these individuals can be complicated and it’s important to evaluate the mechanisms at play and think beyond today’s standards of care. The respiratory tract is a highly balanced system, heavily reliant on the body’s natural ability to maintain optimal temperature, and humidity levels along the entire tract, while providing required respiratory support for the lungs to function. There are significant clinical benefits for patients who use heated humidity in any assisted breathing device. Humidified High Flow Therapy (HHFT) is the new therapy that takes this into account and is pushing the boundaries of what is considered “standard care” and challenging the health care systems to consider HHFT in their COPD treatment plans.  

Perhaps the most well-known device in this space is the Fisher & Paykel Healthcare (F&P) myAirvo2. F&P designed myAirvo2 to fill a need for treating chronic, but stable respiratory patients in the home over prolonged periods of time (as compared to the F&P AIRVO2 device commonly used in the hospital and acute care spaces). The device is designed to mimic the natural physiological balance of heat and moisture in the airway by providing flow and humidification to the respiratory tract. This includes patients who have had the upper airway bypassed.  

The Benefits of Humidification 

1. Assists mucus transport  
2. Promotes efficient gas exchange and ventilation 
3. Increases comfort and tolerance to treatment 
4. Improves QOL  

The myAirvo2 can deliver up to 37 degrees Celsius and 100% relative humidity simultaneously. This is the optimum environment needed for our body to effectively clear secretions from our lungs and re-hydrate our airway. myAirvo2 also provides respiratory support through High Flow delivered via a nasal cannula. This High Flow respiratory support helps reduce the work of breathing while providing dynamic positive airway pressure and increasing alveolar ventilation. This is particularly important for patients suffering from disorders such as COPD, Bronchiectasis, ILD, or even for those using supplemental oxygen that could benefit from heated humidification. 

Who will benefit? 

myAirvo2 can be a life-changing device for patients suffering from many types of chronic airway conditions that cause impaired secretion clearance or spontaneous breathing.  

Recently, the Danish Respiratory Society published guidelines for Nasal High Flow in the home based on a consolidation of clinical research studying the long-term effects of NHF on a variety of chronic airway diseases. Also, VGM updated their respiratory Policies and Procedures to include HHF for patients in the home. Both publications help take the guess work out of identifying, setting up and titrating patients that are new to HHF.  

Payors and health systems could benefit from including HHF into their approved arsenal of therapies, as new research shows a significant improvement in QALY’s and Cost Savings with continued use of myAirvo2 beyond discharge. With value-based care contracts popping up all over the country, it only makes sense to consider utilizing HHF in these models, especially considering the potential for reduced readmissions, costs, and better quality of life. 

So why do I believe in the HHFT? Simply put, I have seen it work. All it takes is one step into a respiratory clinic to know that these patients are suffering at home. I have heard powerful, teary-eyed stories of people with COPD going from wheelchair bound to walking themselves into their doctors’ appointments after using HHFT for only a few short weeks. These stories are the reason I work for F&P and continue to educate anyone that will listen.  

Written by Zach Haynes, Market Development Manager – Airvo, Fisher & Paykel Healthcare, Inc