Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trial

J Hosp Infect. 2019 Jan;101(1):84-87. doi: 10.1016/j.jhin.2018.10.007. Epub 2018 Oct 15.


Whereas high-flow nasal cannula use is gaining prevalence, its high gas flow raises concerns about aerosolization of infectious particles and spread of infection. This randomized controlled crossover non-inferiority trial (N = 20) evaluated the degree of environmental contamination by viable bacteria associated with the use of high-flow nasal cannula compared with conventional oxygen mask for critically ill patients with Gram-negative pneumonia. The results show that high-flow nasal cannula use was not associated with increased air or contact surface contamination by either Gram-negative bacteria or total bacteria, suggesting that additional infection control measures are not required.

Keywords: Bacterial pneumonia; Environmental contamination; Infection control; Infectious disease transmission; Oxygen therapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cannula / adverse effects*
  • Critical Illness*
  • Cross-Over Studies
  • Environmental Pollution*
  • Female
  • Gram-Negative Bacteria / isolation & purification
  • Humans
  • Hyperbaric Oxygenation / adverse effects*
  • Hyperbaric Oxygenation / methods*
  • Male
  • Masks / adverse effects*
  • Middle Aged
  • Pneumonia, Bacterial / therapy*
  • Prevalence