HiFlo guide (West of Scotland Critical Care Guidelines)

Hi-Flo initiation

Neonate <3kg

Neonate >3kg

1-12 months

1-4yrs

5-10yrs

10yrs+

HiFlo device

MR850

Airvo2

Airvo2

Airvo2

Airvo2

Airvo2

Tubing Size

Junior

Junior

Junior

Junior

Junior

Adult

Cannula Size
(<50% nare)

Neonate
(yellow)

Infant
(Purple)

Infant
(Purple)

Paediatric
(Green)

Paediatric
(Green)

S   /   M   /   L
(Blue)

Humidifier Temp.

34oC

34oC

34oC

34oC

34oC

34oC

Initial Settings

8L/min
FiO2 40%
(Unless cardiac with balanced circulation)

10L/min
& adjust O2 flow to give
FiO2 40%
(Unless cardiac with balanced circulation)

12L/min,  
& adjust O2 flow to give
FiO2 40%
(Unless cardiac with balanced circulation)

15L/min
& adjust O2 flow to give
FiO2 40%
(Unless cardiac with balanced circulation)

20L/min
& adjust O2 flow to give
FiO2 40%

30L/min
& adjust O2 flow to give
FiO2 40%

Max Flow Rate

8L/min

20L/min

20L/min

25L/min

25L/min

50 /  60  /  60

Escalation criteria

• Oxygen saturations (SpO2) <94% (NB in cyanotic congenital heart disease this may not apply)
• Tachypnoeic, persistent or worsening respiratory effort despite HiFlo +/- increased WOB
• Tachycardia, persistant or worsening despite HiFlo
• Sustained elevated respiratory component of PEWS score

1st Escalation

Titrate FiO2 to SpO2≥94%
Unless cardiac with balanced circulation

Titrate FiO2 to SpO2≥94%
Unless cardiac with balanced circulation

Titrate FiO2 to SpO2 ≥94%
Unless cardiac with balanced circulation

Titrate FiO2 to SpO2 ≥94%

Titrate FiO2 to SpO2 ≥94%

Titrate FiO2 to SpO2 ≥94%

2nd Escalation

Increase flow up to 8
& urgent PICU review

Increase flow up to
20
& urgent PICU review

Increase flow up to
20
& urgent PICU review

Increase flow up to 25
& urgent PICU review

Increase flow up to 25
& urgent PICU review

Increase flow up to max
& urgent PICU review

3rd Escalation

nCPAP/Intubate

nCPAP/Intubate

NIV/Intubate

NIV/Intubate

NIV/Intubate

NIV/Intubate

 HiFlo for Apneoic oxygenation peri-intubation

Neonate(up to 1 month)

1-12 months

1-4yrs

5-10yrs

10yrs+

Cannula Size
(<50% nare)

Infant

Infant

Paediatric

Paediatric

S   /   M   /   L

Humidifier Temp. (oC)

34

34

34

34

34

Set Flow Rate  (L/min)

2L/kg/min

2L/kg/min

25

25

50 /  60  /  60

FiO2 (%) Unless cardiac with balanced circulation

100

100

100

100

100