Cost-benefit analysis of nasal cannulae in non-tracheally intubated subjects.

Abstract

We evaluated four nasal cannulae used to deliver oxygen and measure PETC02 in a non-tracheally intubated, healthy population. The effect of various oxygen flow rates on PETC02 and respiratory rate (RR), as well as the cost and relative patient comfort of the cannulae, was compared. In this controlled study, 20 healthy volunteers tested the cannulae using oxygen flow rates of 0 (breathing room air), 2, 4, and 6 L/min. The volunteers rated the comfort of each cannula on a scale from 1 (uncomfortable) to 10 (comfortable). Hospital costs of the cannulae were also compared. All of the cannulae, except the Hospitak nasal cannula (HOS), demonstrated an oxygen flow dependency with respect to PETC02 and RR. The HOS cannula was judged by the study population to be the most comfortable and was the second least expensive cannula tested. From a qualitative standpoint, the carbon dioxide waveform recorded with the HOS cannula was the one least affected by oxygen flow. Of the nasal cannula systems evaluated in this study, the HOS system demonstrated the best cost-benefit ratio, performing well clinically while being comfortable to wear and relatively inexpensive. These conclusions are specific to a healthy population and not to patients with lung disease,those who smoke, or those having a higher ASA classification status. Our evaluation suggests that comfort and clinical performance of nasal cannulae may well depend on device design.