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Mr850

Manufactured by Fisher & Paykel Healthcare
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The MR850 is a respiratory humidifier designed for use in medical environments. It is intended to provide humidification for respiratory gases delivered to patients.

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Lab products found in correlation

Optiflow, by Fisher & Paykel Healthcare (4 mentions) Airvo 2, by Fisher & Paykel Healthcare (1 mentions) Airvo2 device, by Fisher & Paykel Healthcare (1 mentions) Optiflow tm, by Fisher & Paykel Healthcare (1 mentions)

8 protocols using mr850

1

Nasal High-Flow Breathing Patterns

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We used an Optiflow NHF cannula and a MR850 heated humidifier (Fisher & Paykel
Healthcare, Auckland, New Zealand) and set the NHF at FIO2 0.21 and the
flow rate at 40 L/min. We asked the participants to breathe five times in succession under
each of the following two situations: open mouth during NHF” (condition O) and “open mouth
while wearing surgical face mask during NHF” (condition OM) (Figure 1). We gave no specific instructions, thus allowing the participants to breathe
freely. We used large nasal cannulas for men and medium sized ones for women. The procedure
lasted approximately 30 min per person.
We calculated mean values by excluding the minimum and maximum values and
calculating the mean of the three remaining values.
Komatsu S., Hara Y., Kuriyama N., Nakamura T., Yamashita C., Komura H., Shibata J, & Nishida O. (2019). Increased intrapharyngeal pressure with combined use of high-flow nasal cannula and a surgical face mask: a preliminary study. Fujita Medical Journal, 5(4), 104-106.
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2

Ventilator Settings and Lung Model Simulation

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A Servo-i ventilator (Servo-I1, Getinge Group Co., Rastatt, Germany) was set in volume control with a tidal volume of 500 mL, a respiratory rate of 20 breaths/min, a positive end expiratory pressure of 5 cm H2O, and an inspiratory time of 1.0 s. Heated humidification (MR850, Fisher & Paykel Healthcare, Inc., Auckland, New Zealand) operating at 37 ± 1 °C was connected to a 7.5 mm endotracheal tube with an inline collecting filter or cascade impactor, and then connected to a lung model with compliance of 0.04 L/cm H2O and resistance of 5 cm H2O/L/s (Training & Test Lungs, Michigan Instrument Inc., Kentwood, MI, USA). The ambient temperature of the lab was 21 °C with 60–65% relative humidity. The endotracheal tube was wrapped with a heated pad to simulate surrounding tissue temperature and minimize reduction of gas temperature and associated condensate.
Liu C.Y., Ko H.K., Fink J.B., Wan G.H., Huang C.C., Chen Y.C, & Lin H.L. (2019). Size Distribution of Colistin Delivery by Different Type Nebulizers and Concentrations During Mechanical Ventilation. Pharmaceutics, 11(9), 459.
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3

High-flow Nasal Therapy for Respiratory Failure

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Patients randomized to the intervention group will receive HFNT (Optiflow and MR850 or AIrVO2™; Fisher & Paykel Healthcare, Auckland, New Zealand), initially set at 60 L/min and a temperature of 37 °C. In the case of discomfort, the flow and/or temperature will be downregulated to the most tolerated setting. In the HFNT group, a rescue NIV treatment will be allowed in the case of worsening of respiratory failure and/or treatment failure, before proceeding with an eventual endotracheal intubation and invasive mechanical ventilation.
Cortegiani A., Longhini F., Carlucci A., Scala R., Groff P., Bruni A., Garofalo E., Taliani M.R., Maccari U., Vetrugno L., Lupia E., Misseri G., Comellini V., Giarratano A., Nava S., Navalesi P, & Gregoretti C. (2019). High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol for a noninferiority randomized clinical trial. Trials, 20, 450.
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4

High-flow Oxygen Therapy for Respiratory Support

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All patients received high-flow oxygen therapy via HFNC device (Optiflow, Fisher & Paykel Healthcare, Auckland, New Zealand). Oxygen was applied continuously by large-bore binasal prongs at a gas flow of 50 L/min with a FiO2 level of 100% initially through a heated humidifier (MR850, Fisher&Paykel Healthcare). Response to treatment was continuously monitored. The aim of oxygenation was to produce peripheral capillary oxygen saturation (SpO2) levels of 92% or more. Patients were treated with complementary non-invasive ventilation according to the intensivist in charge according to local guidelines [19 (link)].
Saillard C., Lambert J., Tramier M., Chow-Chine L., Bisbal M., Servan L., Gonzalez F., de Guibert J.M., Faucher M., Sannini A, & Mokart D. (2022). High-flow nasal cannula failure in critically ill cancer patients with acute respiratory failure: Moving from avoiding intubation to avoiding delayed intubation. PLoS ONE, 17(6), e0270138.
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5

High-Flow Nasal Cannula Protocol

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HFNC was provided with one of the following devices: Optiflow device (MR850 heated humidified delivery tubing and nasal cannula; Fisher & Paykel Healthcare, Auckland, New Zealand)™, Bio-med device high flow air-oxygen blender with the heated humidifier (MR850, Fisher & Paykel Healthcare, Auckland, New Zealand)™ or the Airvo 2 device (Fisher & Paykel Healthcare, Auckland, New Zealand)™. Despite the different devices, all the nasal cannula interfaces were similar to the Airvo2 device, where the nasal cannula is able to deliver humidified respiratory gases up to flows of 70L/min. Physicians initiated HFNC at a minimum flow of 30L/min with FiO2 of at least 30% to target a SpO2 of at least 92%.
Li A., Cove M.E., Phua J., Puah S.H., Ng V., Kansal A., Tan Q.L., Sahagun J.T., Taculod J., Tan A.Y., Mukhopadhyay A., Tay C.K., Ramanathan K., Chia Y.W., Sewa D.W., Chew M., Lew S.J., Goh S., Dhanvijay S., Tan J.J, & FCCP K.C. (2022). Expanding the utility of the ROX index among patients with acute hypoxemic respiratory failure. PLoS ONE, 17(4), e0261234.
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6

High-Flow Nasal Cannula Weaning Criteria

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Adult patients who were treated with HFNC in the ICU were included in this study. The Optiflow TM system with an O2 / air blender and a heated humidifier at 40°C (MR850, Fisher & Paykel Healthcare, Auckland, New Zealand) was used. On the one hand, patients were liberated from HFNC when the HFNC setting was weaned to 30 L / min flow at FIO2 of 0.21-0.30. On the other hand, patients were eligible when oxygen saturation was ≥ 90% with respiratory rate < 40 / min. Exclusion criteria
Takashima T., Nakanishi N., Arai Y, & Oto J. (2021). The effect of high-flow nasal cannula on diaphragm dysfunction including paradoxical diaphragmatic contraction in the intensive care unit. The journal of medical investigation : JMI, 68(1.2).
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7

Effects of HFNC Flow Rate on Airway Pressure

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The flow rate of HFNC was gradually increased to achieve the preset three levels (20, 40, and 60 L/min), and each flow level was maintained for 20 min to maintain a balance of airway pressure. The entire study lasted approximately 80 min. The patient’s condition before HFNC therapy was defined as baseline, which also was taken as zero flow rate of HFNC. Moreover, patients were in a semi-recumbent position during the study period. Conditioned medical air (FiO2 0.30) was delivered via an HFNC (Optiflow, Fisher & Paykel Healthcare, Auckland, New Zealand). The humidifier (MR850, Fisher & Paykel Healthcare, Auckland, New Zealand) temperature was set to 37 °C, and the air was delivered by medium-sized, silicon nasal cannulae (RT050/051, Fisher & Paykel Healthcare, Auckland, New Zealand). The subjects were asked to breathe with their mouth closed during the procedure.
Zhang R., He H., Yun L., Zhou X., Wang X., Chi Y., Yuan S, & Zhao Z. (2020). Effect of postextubation high-flow nasal cannula therapy on lung recruitment and overdistension in high-risk patient. Critical Care, 24, 82.
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8

High-Flow Nasal Oxygen Therapy Outcomes

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This was a retrospective cohort study of subjects from the medical ICU at Medstar Georgetown University Hospital, a tertiary-care center. The study was approved by the institutional review board of Georgetown University. All patients admitted to the medical ICU are anonymously included in a prospectively maintained database in which demographic information, admission diagnosis, medical history, and variables pertinent to their ICU course are recorded. We included as subjects those patients from July 2017 to July 2019 with acute hypoxemic respiratory failure who were newly initiated and maintained on HFNC for at least 6 h, and whose code status allowed for intubation. The success group were subjects weaned off HFNC, whereas the failure group ultimately required invasive mechanical ventilation. The decision to intubate was ultimately determined by the treating clinician. Subjects who transitioned to NIV were excluded. The study center uses a Optiflow HFNC system manufactured by Fisher & Paykel Healthcare (Auckland, New Zealand) with the MR850 heated humidifier and RT232 tubing.
Varipapa RJ J.r., DiGiacomo E., Jamieson D.B., Desale S, & Sonti R. (2021). Fluid Balance Predicts Need for Intubation in Subjects With Respiratory Failure Initiated on High-Flow Nasal Cannula. Respiratory care, 66(4).
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