High flow nasal cannula system: Overview, Uses and Top Manufacturer Company

Posted on February 26, 2026 | by drthomas

Introduction

A High flow nasal cannula system is a respiratory support medical device that delivers a heated and humidified mixture of air and oxygen at higher flow rates than conventional nasal cannula oxygen therapy. In many hospitals, it is used as an intermediate step between standard oxygen delivery (like nasal prongs or simple face masks) and more intensive support (such as noninvasive ventilation or invasive mechanical ventilation).

Why it matters operationally is straightforward: high-flow therapy can be deployed quickly in emergency and acute care settings, it can be more tolerable for many patients than tight-fitting masks, and it often fits well into workflows where continuous monitoring, oxygen infrastructure, and escalation pathways are available. It also carries real safety and resource implications—particularly around oxygen consumption, humidification reliability, infection prevention practices, and the risk of delayed escalation if deterioration is not recognized.

This article is written for two overlapping audiences:

Learners (medical students, residents, trainees): to understand what this clinical device does, how it works in plain language, and how it is used and monitored in real clinical environments.
Hospital decision-makers and support teams (administrators, clinicians, biomedical engineers, procurement, operations): to support safe deployment, standardization, maintenance readiness, cleaning workflows, and supply planning.

You will learn the common uses and limitations of a High flow nasal cannula system, what is typically needed before starting, the basic operation and monitoring approach, what the device “outputs” actually mean, how to troubleshoot safely, and how the global market and service ecosystem varies by country. This is general educational information only; always follow local protocols, clinical supervision, and the manufacturer’s instructions for use (IFU).

What is High flow nasal cannula system and why do we use it?

A High flow nasal cannula system (HFNC) is hospital equipment designed to deliver high-flow, heated, humidified gas (air/oxygen blend) through a nasal cannula interface. Compared with conventional oxygen therapy, HFNC aims to provide more reliable oxygen delivery and better patient comfort—especially when a patient’s inspiratory demand is high.

Clear definition and purpose

At a practical level, HFNC supports patients by providing:

Higher total flow than standard nasal cannula, helping match or exceed the patient’s inspiratory flow demand.
More consistent fraction of inspired oxygen (FiO₂) than low-flow devices that can be significantly diluted by room air during rapid breathing.
Heated humidification, which can improve comfort and support mucociliary function (the airway’s ability to move mucus).

HFNC is a form of oxygen therapy; it is not the same as mechanical ventilation. It does not directly “breathe for” the patient, though it can reduce work of breathing for some patients by improving oxygen delivery conditions and reducing the effort needed to inhale through dry, cold gas.

Common clinical settings

A High flow nasal cannula system may be used across multiple environments, depending on local staffing, monitoring capability, and escalation resources:

Emergency department (ED): rapid initiation for hypoxemia with close observation.
Intensive care unit (ICU): ongoing respiratory support, post-extubation support, and step-down from higher support.
High-dependency unit (HDU)/step-down units: where monitoring is available and staff are trained in escalation.
General wards: in some facilities with defined protocols, monitoring standards, and rapid response capability.
Perioperative and procedural areas: for selected patients needing enhanced oxygenation during sedation or recovery.
Pediatrics/neonatal areas: often with specific protocols and device configurations (varies by manufacturer and facility).

Key benefits in patient care and workflow

From a patient and workflow standpoint, HFNC can be attractive because it is:

Generally better tolerated than tight-fitting masks for many patients (less claustrophobia; easier to speak).
Compatible with eating, drinking, and communication in appropriate patients (under supervision and local policy).
Helpful for secretion management when humidification is working properly.
Less interface-intensive than mask-based noninvasive ventilation (NIV), which can reduce some skin injury risks related to mask pressure (though nasal/ear pressure risks remain).

For hospitals, the operational advantages often include faster deployment than NIV, simplified interface fitting, and scalable use when there are clear protocols and adequate oxygen/humidification support. The operational disadvantages can include high oxygen utilization and the need for reliable consumables and maintenance.

Plain-language mechanism of action (how it functions)

HFNC works through several general mechanisms (the relative contribution of each can vary by patient and by model):

Flow matching: High flow can meet inspiratory demand, reducing the amount of room air entrained around the cannula and helping deliver a more stable FiO₂.
Dead-space washout: High flow can help flush exhaled carbon dioxide (CO₂) from the upper airway (nasopharyngeal dead space), potentially improving breathing efficiency in selected patients.
Low-level positive airway pressure effect: With the mouth closed and at higher flows, a small amount of positive airway pressure may be generated; the magnitude is variable and not equivalent to set positive end-expiratory pressure (PEEP) on a ventilator.
Heated humidification: Warming and humidifying gas reduces mucosal drying, can improve comfort, and supports mucus clearance compared with cold, dry high-flow oxygen.

How medical students typically encounter or learn this device in training

In training, learners often meet HFNC at the bedside rather than in a classroom. Typical learning touchpoints include:

Physiology: understanding FiO₂, work of breathing, dead space, and oxygenation versus ventilation.
Clinical rotations: ED/ICU experiences where the device is initiated, titrated, and monitored.
Escalation planning: learning when HFNC is used as a trial and how to recognize non-response.
Interprofessional workflows: seeing the roles of nursing, respiratory therapy (where available), and biomedical engineering in safe use and readiness.

Because HFNC spans “simple oxygen” and “advanced respiratory support,” it becomes a valuable teaching tool for both patient physiology and hospital operations.

When should I use High flow nasal cannula system (and when should I not)?

Selection for HFNC is a clinical decision that should be made with supervision and local protocols. The device can be helpful in many scenarios, but it can also be inappropriate or insufficient for patients who need immediate airway protection or ventilatory support.

Appropriate use cases (general examples)

HFNC is commonly considered when a patient needs more support than standard oxygen therapy but may not (yet) require NIV or intubation, for example:

Acute hypoxemic respiratory failure where close monitoring is available and escalation pathways are clear.
Pneumonia or atelectasis with increased oxygen requirement (context and severity matter).
Cardiogenic pulmonary edema in selected patients under protocolized care (local practice varies).
Post-extubation support in selected patients as a bridge after invasive ventilation.
Pre-oxygenation and apneic oxygenation support around airway management in controlled settings (protocol-dependent).
Support during certain procedures (such as bronchoscopy or sedation) where oxygenation tends to worsen and rapid escalation is possible.
Pediatric respiratory distress (for example, bronchiolitis) in facilities with pediatric protocols and appropriate cannula sizing.

In some systems, HFNC is also used for symptom relief in selected patients where the goal is comfort and reduced dyspnea, but the decision-making and monitoring approach should be explicit and aligned with local policy.

Situations where it may not be suitable

HFNC may be inappropriate, unsafe, or insufficient in scenarios such as:

Impending respiratory arrest or severe deterioration requiring immediate intubation.
Inability to protect the airway (for example, markedly reduced consciousness, uncontrolled vomiting, or high aspiration risk).
Severe ventilatory failure where the primary problem is CO₂ retention and acidosis requiring ventilatory support (the boundary between oxygenation support and ventilation support must be recognized).
Unstable hemodynamics or shock requiring urgent resuscitation and airway control (context-dependent).
Upper airway obstruction where high-flow delivery does not address the obstruction.
Significant facial/nasal trauma or recent nasal surgery where nasal cannula placement is unsafe or not feasible.
Severe agitation or inability to tolerate the interface when safe application cannot be achieved.

These are general considerations; local protocols and specialist guidance are essential.

Safety cautions and general contraindication themes

Rather than treating contraindications as absolute, many facilities treat them as risk factors requiring senior review. Common safety themes include:

Risk of delayed escalation: If the patient worsens on HFNC and deterioration is not recognized early, definitive airway management may be delayed.
Oxygen infrastructure stress: HFNC can consume substantial oxygen, especially at high flows and high FiO₂; this can challenge pipeline systems, manifolds, and cylinder logistics.
Humidification dependency: If heating/humidification fails, patient discomfort, mucosal injury, thick secretions, or poor tolerance can occur.
Interface pressure injury: Nasal mucosa and skin at the cheeks/ears can be injured without sizing and fixation care.
Infection prevention considerations: Whether HFNC is treated as aerosol-generating may vary by policy and scenario; precaution levels should follow local infection prevention guidance.

The safest framing for learners is: HFNC is powerful, but it is not “set and forget.” It requires planned monitoring, time-limited reassessment, and a clear escalation plan.

What do I need before starting?

Starting HFNC safely is as much about systems and readiness as it is about bedside technique. A High flow nasal cannula system is a piece of medical equipment that depends on reliable gas supplies, appropriate consumables, trained staff, and clear documentation.

Required setup, environment, and accessories

Typical prerequisites include (exact components vary by manufacturer and model):

HFNC base unit (flow generator and/or blender, user interface, alarm system).
Heated humidifier and water chamber (integrated or external; design varies by manufacturer).
Heated breathing circuit (often with heated wire to reduce condensation).
Nasal cannula interface in an appropriate size (adult/pediatric/neonatal sizes vary).
Gas sources: oxygen supply and, for some devices, compressed medical air; other devices may entrain room air internally (varies by manufacturer).
Power supply with a safety-checked electrical outlet; backup power planning for critical areas.
Monitoring equipment: at minimum, continuous pulse oximetry (SpO₂), plus standard vital sign monitoring appropriate to the acuity and local policy.
Suction equipment for secretion management and airway safety as clinically appropriate.
Backup oxygen delivery devices (simple mask, non-rebreather mask) and escalation equipment per local policy.

Consumables planning is not trivial. Many hospitals underestimate the operational impact of maintaining stocks of circuits, cannulas, water chambers, and filters (when used). Compatibility between models matters; standardization can simplify training and inventory.

Training and competency expectations

HFNC can look simple to operate, but safe use requires competency in:

Device setup and pre-use checks
Understanding flow vs FiO₂ vs temperature
Alarm recognition and immediate actions
Patient monitoring and reassessment
Escalation criteria and communication
Infection prevention and cleaning workflows

Competency can be achieved through vendor in-servicing, internal training, and simulation. Many facilities also maintain a “super-user” model (trained champions on each unit) to support safe adoption.

Pre-use checks and documentation

Before use, typical checks include:

Device status: preventive maintenance (PM) label is in date; the device passes self-test.
Physical integrity: no cracks, damaged cables, or loose connectors; no signs of fluid ingress.
Circuit and cannula: correct type and size; packaging intact; within expiry date if applicable.
Humidifier chamber: correct water type per policy (often sterile or distilled water, depending on IFU and facility practice); correct fill level; chamber seated properly.
Gas connections: secure and correct; adequate supply pressure (how this is displayed varies by model).
Alarm settings and audibility: alarms not muted; alarm volume appropriate for the environment.

Documentation expectations vary, but commonly include baseline vitals, respiratory status, starting settings, patient tolerance, and reassessment timing. For quality and traceability, some facilities document consumable lot numbers for certain components (policy-dependent).

Operational prerequisites: commissioning, maintenance readiness, consumables, and policies

From an operations lens, readiness includes:

Commissioning by biomedical engineering: acceptance testing, electrical safety testing, configuration checks, and entry into the asset management system.
Preventive maintenance schedule: aligned to manufacturer guidance and local risk management; clear ownership.
Service model: in-house capability vs vendor service contract; access to parts and turnaround time expectations.
Consumables and logistics: reorder thresholds, storage conditions, and contingency plans for supply disruptions.
Oxygen capacity assessment: pipeline and manifold capacity, especially for high-acuity clusters (ED/ICU) during surges.
Policies and protocols: patient selection, monitoring frequency, escalation triggers, transport rules, and infection prevention measures.

Roles and responsibilities (clinician vs. biomedical engineering vs. procurement)

Clear role separation reduces risk:

Clinicians (physicians/advanced practice providers): decide appropriateness, prescribe targets, and define escalation plans.
Nursing and respiratory therapy (where available): set up therapy, monitor response, manage comfort and skin integrity, respond to alarms, and document reassessments.
Biomedical engineering/clinical engineering: ensure device safety, maintenance, calibration (if applicable), and incident investigation support.
Procurement and supply chain: contract management, standardization decisions, consumable availability, and cost-of-ownership evaluation.
Infection prevention teams: cleaning/disinfection policy alignment and outbreak-era precaution guidance.

HFNC tends to work best when these roles are explicit and practiced, not assumed.

How do I use it correctly (basic operation)?

Exact workflows vary by manufacturer, but the basic logic is consistent: assemble the system, ensure humidification and gas delivery are functioning, apply a correctly sized cannula, and monitor the patient closely while adjusting flow and FiO₂ according to protocol.

Basic step-by-step workflow (common across models)

Confirm the plan and monitoring level
Ensure the indication, monitoring, and escalation plan are defined according to local protocol and supervision.
Gather equipment and consumables
Base unit, humidifier chamber, circuit, cannula, water, and any facility-required filters or adapters.
Perform hand hygiene and apply appropriate PPE
PPE depends on infection prevention policy and patient risk.
Position and power the device safely
Place the unit on a stable surface or approved stand; plug into a safety-checked outlet.
Install or check the humidifier chamber
Fill with the correct water type to the correct level per IFU; seat the chamber properly.
Connect the heated circuit and cannula
Ensure connections are secure and routed to avoid kinks; keep tubing organized to reduce trip hazards.
Connect to gas sources
Attach oxygen (and air if required). Some systems use wall air and wall oxygen; others use an internal flow generator with oxygen input. Configuration varies by manufacturer.
Power on and allow self-check/warm-up
Many devices run a self-test. Humidification may require a short warm-up time; follow the display prompts.
Set initial parameters
Typically:

Flow (liters per minute, L/min)
FiO₂ (fraction of inspired oxygen, often displayed as a percentage)
Temperature (°C)

Apply the cannula to the patient
Choose a cannula size that fits comfortably without fully occluding the nares. Secure it to reduce pressure on the ears and cheeks.
Reassess quickly and then repeatedly
Check comfort, SpO₂, respiratory rate, work of breathing, and mental status. Document the time and settings.

Typical settings and what they generally mean

While local protocols define starting points and targets, it helps to understand what each setting does:

Flow (L/min):
Higher flow generally increases the system’s ability to meet inspiratory demand and may enhance dead-space washout. Higher flow can also increase noise, drying if humidification fails, and patient intolerance if ramped too quickly.
FiO₂:
Adjusting FiO₂ changes the oxygen concentration delivered. The relationship between set FiO₂ and patient oxygenation depends on lung pathology and ventilation-perfusion matching; more oxygen is not always better, and targets should follow local guidance.
Temperature:
Temperature supports humidification and comfort. Many adult applications use temperatures around normal body temperature, but options vary. If temperature is too low, patients may feel cold/dry; if too high, discomfort or thermal risk may increase.

Steps that are commonly universal (even when models differ)

Regardless of brand, several steps consistently matter:

Confirm humidification is active (heated humidification is a core feature of HFNC).
Ensure gas supply is adequate (both pressure and capacity).
Use appropriate cannula sizing and fixation to prevent pressure injury and optimize comfort.
Maintain a clear monitoring and reassessment cadence to detect non-response early.
Keep a backup oxygen delivery method immediately available.

Notes for learners and new operators

HFNC is often started in busy areas (ED/ICU) where distractions are common. Safe operation improves when you adopt a habit of:

Looking at the patient first, then the device.
Verifying the three main settings (flow, FiO₂, temperature) at every handover.
Checking for silent failures (empty water chamber, disconnected tubing, kinked circuit) when the patient appears uncomfortable or deteriorates.

How do I keep the patient safe?

Patient safety with a High flow nasal cannula system is a combination of correct setup, continuous clinical observation, alarm literacy, and a culture of escalation. HFNC can make patients look more comfortable quickly, which is helpful—but it can also mask fatigue or deterioration if staff rely on comfort alone.

Safety practices and monitoring (what “good” looks like)

Facility protocols vary, but safe practice typically includes:

Baseline assessment before initiation: respiratory rate, SpO₂, heart rate, blood pressure, mental status, and work of breathing.
Early reassessment after starting: confirm tolerance, check SpO₂ response, and ensure the cannula remains positioned properly.
Ongoing monitoring: continuous SpO₂ is common; frequency of full vital signs depends on acuity and local standards.
Clinical trajectory awareness: monitor whether oxygen needs are decreasing, stable, or escalating over time.

Importantly, HFNC addresses oxygenation support more than ventilation support. If the patient’s primary problem is CO₂ retention, sedation, or profound ventilatory failure, HFNC may not be the right tool without specialist oversight.

Alarm handling and human factors

HFNC alarms vary by model but often include:

Low oxygen supply pressure / supply failure
Disconnection / leak
High temperature / low temperature
Low water / humidifier fault
System fault or failed self-test

Human factors to plan for:

Alarm fatigue: ensure alarms are audible and actionable; avoid silencing without resolving the cause.
Handover reliability: communicate settings and trends clearly (flow/FiO₂/temperature + patient response).
Standardized consumables: mismatched circuits/cannulas can cause poor performance or leaks; standardization reduces setup errors.

Risk controls in everyday practice

Risk reduction is usually achieved through simple, repeatable controls:

Correct cannula size: too small can leak excessively; too large can cause pressure injury and discomfort.
Skin protection: padding behind ears, regular skin checks, and repositioning reduce device-related injury.
Condensation management: keep tubing positioned to minimize pooled water migrating toward the patient; handle water traps per IFU.
Avoiding accidental dislodgement: secure tubing and cannula; consider mobility plans early.
Oxygen safety: high oxygen environments increase fire risk; enforce no-smoking rules and follow perioperative oxygen precautions.

Labeling checks and traceability

From a safety and quality standpoint, consider:

Confirming single-use vs reusable status of patient-contact components.
Using cleaning logs for base units where required.
Maintaining traceability for consumables when your facility policy requires it (especially during recall or defect investigations).

Incident reporting culture (general expectations)

HFNC is used frequently in high-acuity scenarios where incidents can occur. A safety culture approach includes:

Reporting device malfunctions and near-misses through the facility’s incident system.
Preserving evidence (device, circuit, alarms history if available) when a significant event occurs.
Involving biomedical engineering early when performance is suspect.
Not blaming individuals for system-level failures like consumable shortages or unclear protocols.

The overarching safety principle is: HFNC should never replace vigilance. Comfort is reassuring, but objective reassessment and escalation readiness are essential.

How do I interpret the output?

A High flow nasal cannula system typically provides settings and system status, not diagnostic measurements of patient physiology. Interpreting “output” therefore means understanding what the device is delivering and how the patient is responding clinically.

Types of outputs/readings you may see

Depending on the model, the device display may show:

Set flow (L/min) and sometimes delivered flow
Set FiO₂ and sometimes a measured FiO₂ (if an oxygen sensor/analyzer is present; varies by manufacturer)
Temperature setpoint and current temperature
Humidifier status (heating active, warm-up, fault)
Supply pressure indicators or warnings (model-dependent)
Alarm codes/messages and event prompts
Usage time or therapy timers (model-dependent)

In many setups, key “outputs” are actually external to the device:

Pulse oximetry (SpO₂)
Respiratory rate and work of breathing
Arterial blood gas (ABG) or capillary gas when clinically indicated and available
Patient comfort and ability to speak/clear secretions

How clinicians typically interpret them (in general terms)

A safe interpretation pattern is:

Confirm the device is delivering what you think it is delivering (flow/FiO₂/temperature).
Interpret changes in SpO₂ and respiratory distress as the primary signals of response.
Look for trend consistency: is the patient improving, stable, or progressively requiring higher FiO₂/flow?
Escalate concern when objective measures worsen, even if the patient looks “calmer” (fatigue can reduce visible effort while risk increases).

Some units use structured reassessment tools and local indices to track response. If your facility uses such tools, learn their inputs, limitations, and how they guide escalation timing.

Common pitfalls and limitations

HFNC output interpretation has predictable traps:

SpO₂ artifacts: poor perfusion, motion, nail polish, sensor malposition, or dyshemoglobinemias can mislead.
Mouth breathing and leaks: can reduce the effective pressure and change the delivered experience; device settings may be unchanged while patient benefit declines.
Over-reliance on FiO₂: increasing FiO₂ may improve SpO₂ temporarily while work of breathing worsens; this can delay needed escalation.
Ventilation is not measured: HFNC does not provide tidal volume, minute ventilation, or direct CO₂ removal metrics; worsening hypercapnia may be missed without appropriate assessment.
Supply limitations: in constrained oxygen systems, delivered performance may drop if supply pressure or flow capacity cannot keep up (device-dependent).

The key principle is clinical correlation: device settings are inputs; patient physiology and trajectory are the outputs that matter most.

What if something goes wrong?

Problems with HFNC usually fall into two categories: patient deterioration (clinical failure) or equipment/system failure (technical or supply issue). The response should prioritize patient safety and escalation pathways.

A practical troubleshooting checklist (start with the patient)

Assess the patient first
Check airway patency, breathing effort, SpO₂ waveform quality, mental status, and hemodynamic stability. Call for help early if deterioration is significant.
Ensure the cannula is positioned correctly
Re-seat prongs, check strap tension, and look for kinks or occlusion.
Check for disconnections and leaks
Trace tubing from patient to device; confirm secure connections and that the circuit is intact.
Confirm gas supply
Verify wall oxygen is connected, valves are open, and supply pressure/availability is adequate. If using cylinders, confirm remaining volume and regulator function.
Check humidification and water chamber
Confirm correct water level, proper chamber seating, and that heating is active without fault indicators.
Review device settings and alarm messages
Ensure flow/FiO₂/temperature are as intended; read the alarm text/code rather than guessing.
Manage condensation safely
If water pooling is present, handle it per IFU. Avoid allowing water to drain toward the patient.
Switch to backup oxygen if needed
If technical issues persist or the patient is unstable, move to a simpler, reliable oxygen delivery method per local protocol while troubleshooting continues.

When to stop use (general guidance)

Stop HFNC and escalate immediately if:

The patient shows signs of severe respiratory failure or exhaustion requiring urgent escalation.
There is a significant change in mental status suggesting inability to protect the airway.
There is an unresolved device fault affecting delivery (for example, repeated critical alarms, loss of gas delivery, or overheating) and no rapid fix is available.
Local protocols specify time-limited trials and the patient is not meeting response criteria.

This is not a substitute for clinical judgment. The point is to avoid “therapeutic inertia” where a patient remains on HFNC despite deterioration.

When to escalate to biomedical engineering or the manufacturer

Involve biomedical engineering when you see:

Failed self-tests, recurring fault codes, or unexpected shutdowns
Suspected inaccurate FiO₂ delivery (especially if an oxygen sensor is present and discrepant)
Evidence of physical damage, burning smell, unusual noise, or fluid ingress
Repeated humidifier heating failures not explained by setup error

Escalate to the manufacturer (through your facility’s established channels) for:

Suspected device-related adverse events
Recurring issues across multiple units
Questions about approved disinfectants, consumable compatibility, or software updates (varies by manufacturer)

Documentation and safety reporting expectations

When things go wrong, good documentation protects patients and helps the system improve:

Record the time, settings, alarms, and patient status.
Document the actions taken and the patient response.
If equipment malfunction is suspected, label and quarantine the device per local policy and preserve consumables involved if required.
Submit an incident report per your facility process and involve the appropriate safety teams.

Infection control and cleaning of High flow nasal cannula system

HFNC sits at the intersection of respiratory care and humidification, which makes infection prevention and cleaning practices especially important. The details depend on whether components are single-use or reusable, and on local infection prevention policy.

Cleaning principles (what to aim for)

Treat patient-contact components as high-risk for contamination.
Prioritize standard work: consistent steps, correct disinfectant, correct contact time, and documentation.
Avoid improvised cleaning methods that can damage surfaces, seals, or sensors.

Disinfection vs. sterilization (general)

Cleaning removes visible soil and reduces bioburden; it is usually the first step.
Disinfection uses chemicals to reduce microorganisms on surfaces; levels vary (low/intermediate/high).
Sterilization eliminates all forms of microbial life; it is not typically applied to the HFNC base unit and is usually reserved for certain reusable instruments.

For HFNC, many patient-contact items (cannula, circuit, water chamber) are often managed as single-patient-use or disposable items. Whether anything is reusable is manufacturer- and facility-policy dependent.

High-touch points to remember

Even if the patient circuit is replaced, contamination can persist on the base unit and accessories. Common high-touch areas include:

Touchscreen or display panel
Control knobs/buttons
Handles and push bars
Pole clamps and mounting points
Power switch and power cable
External gas connectors and nearby surfaces

Example cleaning workflow (non-brand-specific)

A typical between-patient workflow might look like this (always follow IFU and policy):

Perform hand hygiene and don appropriate PPE.
Power down the unit safely if required by the IFU.
Disconnect and discard single-use patient-contact items per waste policy.
Inspect the base unit for visible soil, cracks, or fluid contamination.
Clean and disinfect external surfaces using facility-approved wipes/solutions.
Ensure correct wet contact time (do not immediately dry unless the product requires it).
Allow surfaces to dry fully and inspect again.
Replace any protective covers or accessories as defined by policy.
Document cleaning (log, sticker, or digital record per local system).
Store the unit in a clean area to prevent recontamination.

Additional considerations (policy-dependent)

Aerosol precautions: Whether HFNC is treated as aerosol-generating can vary by setting and pathogen; follow local infection prevention guidance for room placement, PPE, and masking practices.
Water management: Use the water type specified by IFU; avoid “topping up” practices that can increase contamination risk (facility policies differ).
Consumable compatibility: Using non-approved circuits/chambers can create fit issues and may complicate cleaning validation; standardization helps.

Medical Device Companies & OEMs

Procurement and operations teams often encounter overlapping terms—manufacturer, OEM, brand owner, and private label—that can affect serviceability, consumable compatibility, and accountability.

Manufacturer vs. OEM (Original Equipment Manufacturer)

A manufacturer is the entity responsible for producing a medical device and meeting applicable regulatory and quality system requirements for that product.
An OEM is a company that produces components or complete devices that may be sold under another company’s brand (the “brand owner”). In some arrangements, the OEM and manufacturer are the same; in others, they are distinct.

In respiratory care and humidification-related hospital equipment, OEM relationships can appear in:

Shared platforms sold under different names
Rebranded accessories or consumables
Regional distribution models where support is provided by partners

How OEM relationships impact quality, support, and service

For hospitals, OEM structures can influence:

Service pathways: Who provides field service, training, and parts—manufacturer, local subsidiary, or third party.
Consumable lock-in and compatibility: Whether circuits/cannulas are proprietary or cross-compatible (varies by manufacturer).
Warranty terms and turnaround times: Often driven by local representation and contract structure.
Recall/notice communications: Clarity about who communicates safety notices and how traceability is managed.

When evaluating a High flow nasal cannula system, it is reasonable to ask for clarity on the legal manufacturer, authorized service channels, availability of parts, and the expected lifecycle support model.

Top 5 World Best Medical Device Companies / Manufacturers

Example industry leaders (not a ranking). Specific High flow nasal cannula system offerings vary by manufacturer and region.

Medtronic
Medtronic is widely known for a broad portfolio spanning cardiovascular, surgical, and critical care-related products. In many markets, its hospital presence is supported by large-scale training and service infrastructure. Device categories commonly associated with the company include patient monitoring and respiratory/airway-adjacent products, though exact HFNC availability varies by region. Large manufacturers often operate through complex distribution and service networks, so local support capability should be verified.
Johnson & Johnson (MedTech)
Johnson & Johnson’s MedTech portfolio is commonly associated with surgical technologies, orthopedics, and interventional solutions. Its global footprint and structured quality systems influence how hospitals evaluate vendor governance and supply reliability. While not primarily identified as an HFNC platform provider, the company’s scale makes it a frequent reference point in procurement conversations about supplier maturity. As with any large organization, local availability and support models vary.
Philips
Philips is broadly associated with hospital monitoring, imaging, and certain respiratory care categories. Its global presence can be attractive for facilities seeking standardized training and service across sites, although product portfolios differ by country. Buyers should verify current product availability, service bulletins, and local support capability for any specific model under consideration. As with many major manufacturers, safety communications and product notices are part of routine lifecycle governance.
GE HealthCare
GE HealthCare is commonly recognized for imaging, monitoring, and digital hospital solutions, often integrated into enterprise workflows. For procurement teams, such integration can matter when planning device connectivity, alarms management, and centralized monitoring strategies. HFNC-specific portfolios are not the company’s primary association in many markets, so facilities typically assess GE HealthCare more for adjacent infrastructure that supports respiratory care delivery. Local service reach is a key differentiator to confirm.
Siemens Healthineers
Siemens Healthineers is widely associated with diagnostic imaging, laboratory diagnostics, and digital health infrastructure. While it is not typically known as a primary HFNC platform manufacturer, it frequently influences respiratory care pathways through diagnostics and monitoring ecosystems. For hospital leaders, the relevance is often in interoperability, enterprise service models, and long-term support contracts. As always, confirm the scope of local offerings and service coverage.

Vendors, Suppliers, and Distributors

Even the best clinical device can fail operationally if the vendor ecosystem is unclear. Hospitals often use “vendor,” “supplier,” and “distributor” interchangeably, but the roles can differ in ways that affect pricing, lead times, and accountability.

Role differences between vendor, supplier, and distributor

Vendor: a broad term for any company selling goods/services to the hospital (may include manufacturers, distributors, or service providers).
Supplier: often emphasizes the entity providing the product consistently (including consumables and accessories); may be a manufacturer or an intermediary.
Distributor: focuses on logistics and commercial distribution—warehousing, delivery, returns, and sometimes first-line technical support.

In practice, your contract may involve more than one party: a manufacturer sets product specifications, a distributor handles local stocking and delivery, and a service partner provides maintenance.

Top 5 World Best Vendors / Suppliers / Distributors

Example global distributors (not a ranking). Availability and service scope vary by country and region.

McKesson
McKesson is commonly recognized as a large healthcare distribution organization in certain markets, supporting hospitals with broad product catalogs and logistics services. For respiratory consumables, buyers often value predictable delivery and integrated procurement workflows. Service scope varies and may focus more on distribution than on device repair. Local presence differs significantly outside core markets.
Cardinal Health
Cardinal Health is associated with medical-surgical distribution and supply chain services in multiple regions. Hospitals may engage such distributors to stabilize consumable availability, especially for high-velocity items used with HFNC. Depending on the region, support offerings can include inventory management programs. The specifics of device servicing and clinical training typically depend on manufacturer agreements.
Medline
Medline is widely known for medical-surgical supplies and large-scale hospital procurement relationships in many systems. For HFNC operations, this can matter in the consistent availability of related consumables and ward supplies that support respiratory care. Distribution reach and on-site support models vary by country. Buyers should confirm whether the distributor is authorized for specific device categories.
Owens & Minor
Owens & Minor is often associated with healthcare logistics and supply chain services, including distribution of medical consumables. In some settings, such organizations support consolidated purchasing and standardized delivery schedules. For HFNC, operational value is often tied to reliable supply of circuits, cannulas, and ancillary items (where included in the catalog). Regional availability and service offerings vary.
Henry Schein
Henry Schein is widely recognized in healthcare distribution, with strong presence in certain sectors and geographies. While frequently associated with dental and outpatient supply chains, procurement teams sometimes interact with such distributors for broader medical supplies depending on the market structure. For HFNC-related purchasing, the key questions are authorization status, lead times, and return/support processes. Coverage and product scope differ by region.

Global Market Snapshot by Country

India

Demand for High flow nasal cannula system in India is strongly influenced by ICU expansion, growing private hospital networks, and persistent respiratory disease burdens. Many facilities depend on imports for complete systems, while local manufacturing may focus more on accessories or adjacent hospital equipment (varies by company). Urban tertiary centers typically have stronger oxygen infrastructure and service coverage than rural facilities, shaping where HFNC can be used safely at scale.

China

China’s market is shaped by large hospital networks, strong domestic manufacturing capability in many medical device categories, and significant investment in critical care infrastructure. Availability of HFNC platforms can include both imported and domestically produced options, with purchasing often influenced by tender processes and local standards. Service ecosystems are typically stronger in major cities than in remote regions, affecting maintenance turnaround and training consistency.

United States

In the United States, HFNC is widely integrated into ED and ICU respiratory support pathways, supported by established respiratory therapy staffing models in many hospitals. Purchasing decisions often emphasize evidence review, standardization, consumable costs, and service contracts, with a mature distributor and group purchasing organization (GPO) landscape influencing procurement. Access is generally strong in urban and suburban centers, while smaller rural hospitals may be more sensitive to staffing, monitoring capacity, and oxygen supply constraints.

Indonesia

Indonesia’s demand is driven by expanding hospital capacity, variable oxygen infrastructure, and differences in care delivery between urban referral centers and rural facilities. Import dependence can be substantial for complete HFNC systems, and maintenance capability may be uneven across islands, making service planning a key part of procurement. Facilities may prioritize models that are robust, simple to maintain, and supported by reliable local distributors.

Pakistan

In Pakistan, HFNC adoption is often concentrated in tertiary care hospitals where ICU staffing, monitoring, and oxygen supply are more reliable. Import dependence and currency-related procurement constraints can affect availability and standardization. Service support and consumable supply continuity are major considerations, particularly outside major urban centers.

Nigeria

Nigeria’s market is influenced by mixed public-private healthcare delivery, variable oxygen availability, and significant differences between tertiary urban hospitals and rural facilities. HFNC can be valuable in higher-acuity centers, but sustained use depends on oxygen supply reliability, trained staff, and access to consumables. Procurement often requires careful planning for after-sales support and contingency oxygen strategies.

Brazil

Brazil combines a large hospital sector with regional variability in resources and procurement pathways. HFNC demand is shaped by ICU capacity, public sector purchasing processes, and private hospital investment in respiratory care. Import and domestic supply mixes vary by manufacturer, and service coverage may be stronger in major metropolitan regions than in remote areas.

Bangladesh

Bangladesh’s demand is tied to growing critical care capacity and the operational lessons many facilities have faced around oxygen delivery systems and surge planning. HFNC availability may rely heavily on imports and distributor networks, making consumable continuity and training programs essential. Urban hospitals tend to have more consistent monitoring and biomedical support than district facilities, influencing safe deployment.

Russia

In Russia, procurement is shaped by centralized purchasing structures in some regions, import constraints that can vary over time, and the need for local serviceability. Facilities often evaluate HFNC platforms alongside broader critical care equipment strategies, including compatibility with existing oxygen infrastructure. Urban centers are more likely to have established biomedical engineering support and parts availability.

Mexico

Mexico’s HFNC market reflects a combination of public sector procurement and private hospital investment, with notable variation in access between large cities and more remote areas. Import dependence is common for complete systems, and distributor capability plays a significant role in training and after-sales service. Hospitals often prioritize total cost of ownership, including consumables and maintenance, rather than base unit price alone.

Ethiopia

In Ethiopia, HFNC adoption is closely tied to oxygen system capacity, training availability, and the growth of critical care services in referral hospitals. Import dependence and logistical complexity can challenge consistent access to consumables and timely maintenance. Urban tertiary centers are more likely to deploy HFNC routinely, while rural hospitals may prioritize more basic oxygen delivery methods due to infrastructure constraints.

Japan

Japan’s market is characterized by high standards for hospital equipment reliability, established clinical engineering roles, and structured procurement and maintenance processes. HFNC usage is supported by strong monitoring infrastructure and mature service ecosystems, though device selection and protocols can be highly standardized within institutions. Aging demographics and respiratory care needs can influence demand for comfortable, well-tolerated oxygen delivery modalities.

Philippines

In the Philippines, HFNC demand is shaped by urban tertiary hospital growth, private sector investment, and variable oxygen and staffing resources across regions. Import dependence is common for complete systems, and distributor training and service support can be decisive. Rural and island geographies can complicate maintenance logistics, making uptime planning and spare parts strategies important.

Egypt

Egypt’s HFNC adoption is influenced by the scale of public hospital networks, expanding private healthcare, and ongoing investment in acute care capabilities. Import reliance and procurement cycles can impact equipment standardization across facilities. Service ecosystem strength varies, so hospitals often evaluate local distributor capability and biomedical support access alongside device specifications.

Democratic Republic of the Congo

In the Democratic Republic of the Congo, the practical market for HFNC is constrained by infrastructure challenges, including oxygen availability, power reliability, and limited biomedical engineering coverage in many areas. Where HFNC is used, it is more likely to be in larger urban or mission-supported facilities with stronger supply chains. Procurement planning often centers on robustness, training, and long-term consumable access rather than advanced features.

Vietnam

Vietnam’s HFNC market is supported by expanding hospital capacity and increasing investment in critical care, particularly in major cities. Import dependence remains relevant, but distributor networks and local service capabilities have been developing in many regions. Urban-rural gaps in monitoring and staffing can influence where HFNC is deployed and how safely it can be monitored.

Iran

Iran’s demand is influenced by local manufacturing in some medical device areas, evolving import conditions, and a strong emphasis on serviceability and parts access. Hospitals may prioritize devices with clear maintenance pathways and accessible consumables. Urban tertiary centers tend to lead adoption, while smaller hospitals may be more constrained by oxygen infrastructure and staffing.

Turkey

Turkey has a sizable healthcare sector with a mix of public and private providers and an established medical device distribution landscape. HFNC adoption is influenced by ICU capacity, procurement frameworks, and the availability of local training and service. Hospitals often evaluate not only device performance but also warranty terms, response time for repairs, and consumable supply continuity.

Germany

Germany’s market is characterized by mature hospital infrastructure, strong biomedical/clinical engineering support, and structured procurement processes that emphasize safety and lifecycle management. HFNC is typically integrated within well-defined respiratory care pathways and supported by reliable oxygen systems. Buyers often focus on interoperability, alarm safety, infection control compatibility, and long-term service contracts.

Thailand

Thailand’s HFNC demand is influenced by expanding tertiary care, medical tourism in some private systems, and variability in resources between Bangkok/major cities and rural provinces. Import dependence is common for complete systems, making distributor strength and training programs important. Facilities often weigh oxygen infrastructure capacity and consumable logistics carefully when scaling HFNC use.

Key Takeaways and Practical Checklist for High flow nasal cannula system

High flow nasal cannula system is oxygen therapy with heated humidification and higher flow delivery.
Define HFNC goals explicitly: oxygenation support, comfort, and monitored response over time.
Confirm your facility’s protocol for where HFNC can be used (ED, ICU, ward) and by whom.
Always assess the patient first; device settings are inputs, not outcomes.
Verify oxygen infrastructure capacity before scaling HFNC across units.
Plan for high oxygen consumption during surges and in high-acuity clusters.
Use the correct cannula size to reduce pressure injury and improve tolerance.
Secure tubing to prevent accidental dislodgement during repositioning and transport.
Check the humidifier water chamber level and seating before starting.
Use only water type and fill levels specified by IFU and facility policy.
Confirm heated humidification is active; dry gas is a common tolerance failure point.
Trace the circuit end-to-end to catch kinks, loose connections, and misassembly.
Ensure alarms are audible and never rely on a muted device in a busy ward.
Treat repeated alarms as a safety signal, not a nuisance.
Document baseline status and the initial flow/FiO₂/temperature at initiation.
Reassess early after initiation and set a clear reassessment schedule.
Watch trends: rising FiO₂ needs or worsening work of breathing requires escalation planning.
Do not assume improved comfort equals clinical improvement; fatigue can be deceptive.
Remember HFNC does not measure ventilation; CO₂ problems may need different monitoring.
Use reliable SpO₂ waveforms; poor signal quality can mislead decisions.
Maintain a backup oxygen delivery method at the bedside in case of device failure.
Manage condensation per IFU; prevent pooled water from reaching the patient.
Apply skin checks for nares, cheeks, and ears at regular intervals.
Follow oxygen fire safety rules rigorously in high FiO₂ environments.
Clarify transport rules; many HFNC systems are not designed for long transports without planning.
Engage biomedical engineering for commissioning, PM scheduling, and fault investigations.
Standardize models and consumables where possible to reduce training and inventory complexity.
Confirm authorized service pathways and parts availability during procurement.
Include consumables and service in total cost of ownership, not just base unit pricing.
Align cleaning workflows with infection prevention policy and manufacturer IFU.
Treat patient-contact circuits/cannulas as single-use unless IFU explicitly allows reprocessing.
Clean and disinfect high-touch external surfaces between patients and per policy.
Use incident reporting for malfunctions, near-misses, and unexpected clinical deterioration.
Build escalation culture: HFNC should have clear “failure criteria” in local protocols.
Train staff on alarm meanings, not just button-pressing sequences.
Keep a unit-level quick guide with common alarms and first-line checks.
Audit documentation quality and reassessment timing during quality improvement reviews.
Include HFNC readiness in oxygen system risk assessments and emergency preparedness plans.
Ensure procurement verifies country-specific availability, warranty terms, and distributor capability.
Recheck settings at every handover: flow, FiO₂, temperature, and patient response trend.

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