[Experience with high-flow nasal cannula oxygen therapy in children]

To analyze the efficacy of a high-flow oxygen therapy system in children with moderate respiratory failure and/or high oxygen requirements.

We performed a prospective, observational clinical study of patients treated with a high-flow oxygen therapy system via nasal cannulae. The following variables were analyzed: clinical severity score, respiratory rate, heart rate, clinical improvement, oxygen saturation, blood gases, complications, and the need for ventilation after starting the treatment.

Eighteen treatments were studied in 16 patients (two girls and 14 boys) aged between 2 and 156 months. With the high-flow oxygen therapy system, respiratory rate slightly decreased from 34.5 bpm to 32.2 bpm (p<0.04) and O2 saturation increased from 90.2% to 93.5% (p<0.02). Fourteen patients showed a clinical improvement and/or tolerated the change from the previous respiratory assistance. The duration of treatment was 3 days (range: 6 hours to 25 days). Mild complications (initial irritability and excessive humidity) were observed in two patients, but treatment interruption was not required. No secondary respiratory tract infections were observed. The system was withdrawn in four patients, due to lack of improvement in two patients, deterioration after initial improvement in one patient, and failure of the system's temperature regulation in one patient.

The high-flow oxygen therapy system is effective in a large percentage of children with high oxygen requirements and/or moderate respiratory failure.