High Flow Nasal Cannula Oxygen Therapy for Acute Pulmonary Oedema Post-Cesarean Sectionin Severe Preeclampsia

Acute dyspnea with accompanying hypoxemia in post-surgical patients is a major problem in the intensive care unit. A oxygen therapy is an essential supportive treatment to correct these issues. High-Flow nasal cannula (HFNC) oxygen therapy has been an innovative and effective alternative respiratory support for critically ill patients, because of its physiological advantages compared with other standard oxygen therapies [1]. However evidence is uneven because the reports cover various subjects with diverse underlying conditions. Even so, across the diversity, many published reports suggest that HFNC decreases breathing frequency and work of breathing and reduces the need for respiratory support escalation [2]. Carlucci A et al. (2001) determined in their study with respect to non-invasive ventilation (NIV): “poor tolerance is a risk factor of NIV failure” [3]. Despite the fact that NIV can produce significant clinical improvement, patients often reject it or fail to use it appropriately. Correctly use of NIV is crucial, given that adherence to medication decreases over time and is inversely related to the number of drugs prescribed. Clinical experience suggests that patients with psychological alterations, such as anxiety and depression are less likely to accept and comply with NIV regimes [4]. Pre- and post-surgical stress and the obstetric patient because of their particular conditions clearly influence the rejection of NIV. According to the most recent literature, there is only one case of use of non-invasive ventilation in a critically ill obstetric patient with non-cardiogenic pulmonary oedema (during cesarean and later ICU) and good tolerance [5].