Introduction: In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis. Methods: We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospital over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years. Results: No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ2 = 1.007, p > 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ2 = 2.082, p > 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate <5 L/min and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ2 = 0.838, p > 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ2 = 18.428, p < 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ2 = 26.194, p < 0.001). Discussion/Conclusion: Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated epistaxis to a certain extent.

1.
Kallstrom
TJ
.
AARC Clinical Practice Guideline: oxygen therapy for adults in the acute care facility: 2002 revision and update
.
Respir Care
.
2002
;
47
(
6
):
717
37
.
2.
Kelly
MG
,
McGarvey
LP
,
Heaney
LG
,
Elborn
JS
.
Nasal septal perforation and oxygen cannulae
.
Hosp Med
.
2001
;
62
(
4
):
248
.
3.
Wu
K
,
Ahmed
A
,
Woolford
TJ
.
Treatment of home oxygen induced rhinitis: an unusual use for a nasal obturator
.
Rhinology
.
2004
;
42
(
4
):
244
5
.
4.
Miyamoto
K
,
Nishimura
M
.
Nasal dryness discomfort in individuals receiving dry oxygen via nasal cannula
.
Respir Care
.
2008
;
53
(
4
):
503
4
.
5.
Chanques
G
,
Constantin
JM
,
Sauter
M
,
Jung
B
,
Sebbane
M
,
Verzilli
D
,
Discomfort associated with underhumidified high-flow oxygen therapy in critically ill patients
.
Intensive Care Med
.
2009
;
35
(
6
):
996
1003
. .
6.
Nishimura
M
.
High-flow nasal cannula oxygen therapy in adults: physiological benefits, indication, clinical benefits, and adverse effects
.
Respir Care
.
2016 Apr
;
61
(
4
):
529
41
. .
7.
Spoletini
G
,
Alotaibi
M
,
Blasi
F
,
Hill
NS
.
Heated humidified high-flow nasal oxygen in adults: mechanisms of action and clinical implications
.
Chest
.
2015 Jul
;
148
(
1
):
253
61
. .
8.
C Gotera 1
,
Díaz Lobato
S
,
Pinto
T
,
Winck
JC
.
Clinical evidence on high flow oxygen therapy and active humidification in adults
.
Rev Port Pneumol
.
2013 Sep–Oct
;
19
(
5
):
217
27
.
9.
Magnussen
H
,
Goeckenjan
G
,
Köhler
D
,
Matthys
H
,
Morr
H
,
Worth
H
,
[Guidelines to long-term oxygen therapy]
.
Pneumologie
.
2001
;
55
(
10
):
454
64
. Article in German. .
10.
Campbell
EJ
,
Baker
MD
,
Crites-Silver
P
.
Subjective effects of humidification of oxygen for delivery by nasal cannula. A prospective study
.
Chest
.
1988
;
93
(
2
):
289
93
. .
11.
Andres
D
,
Thurston
N
,
Brant
R
,
Flemons
W
,
Fofonoff
D
,
Ruttimann
A
,
Randomized double-blind trial of the effects of humidified compared with nonhumidified low flow oxygen therapy on the symptoms of patients
.
Can Respir J
.
1997
;
4
(
2
):
76
80
. .
12.
O’Driscoll
BR
,
Howard
LS
,
Davison
AG
;
British Thoracic Society
.
BTS guideline for emergency oxygen use in adult patients
.
Thorax
.
2008
;
63
(
Suppl 6
):
vi1
68
. Erratum in: Thorax. 2009;64(1):91.
13.
American Thoracic Society
.
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease
.
Am J Respir Crit Care Med
.
1995
;
152
(
5 Pt 2
):
S77
121
.
14.
AARC clinical practice guideline. Oxygen therapy in the home or extended care facility. American Association for Respiratory Care
.
Respir Care
.
1992 Aug
;
37
(
8
):
918
22
.
15.
Miyamoto
K
.
[Is it necessary to humidify inhaled low-flow oxygen or low-concentration oxygen?]
.
Nihon Kokyuki Gakkai Zasshi
.
2004 Feb
;
42
(
2
):
138
44
.
16.
McMullin
B
,
Atkinson
P
,
Larivée
N
,
Chin
CJ
.
Examining seasonal variation in epistaxis in a maritime climate
.
J Otolaryngol Head Neck Surg
.
2019 Dec 30
;
48
(
1
):
74
. .
17.
Kemal
O
,
Sen
E
.
Does the weather really affect epistaxis?
B-ENT
.
2014
;
10
(
3
):
199
202
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.