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High Flow Nasal Cannula Therapy as a Primary Mode of Respiratory Support in a Pediatric Intensive Care Unit

Sachin Shah1, Amita Kaul2, Rupesh Bhosale1

  • 1Department of Neonatal and Pediatric Intensive Care Services, Surya Mother and Child superspecialty Hospital, Pune, Maharashtra, India.

Indian Pediatrics
|October 9, 2020
PubMed

Insights

High flow nasal cannula therapy (HFNC) is effective and safe for treating pediatric respiratory distress. Most children responded well to HFNC, showing significant clinical improvement within hours.

Area of Science:

  • Pediatric Pulmonology
  • Critical Care Medicine
  • Respiratory Therapy

Background:

  • Respiratory distress is a common and serious condition in children.
  • Non-invasive respiratory support is crucial for managing pediatric respiratory distress.
  • High flow nasal cannula (HFNC) therapy is increasingly used, but its primary role needs further evaluation.

Purpose of the Study:

  • To evaluate the efficacy and safety of High flow nasal cannula therapy (HFNC) as a primary treatment for pediatric respiratory distress.
  • To compare clinical outcomes in children treated with HFNC versus those requiring mechanical ventilation.

Main Methods:

  • Prospective assessment of consecutive pediatric patients (1 month to 16 years) with respiratory distress.
  • Utilized respiratory clinical score, COMFORT score, and saturation to FiO2 (SF) ratio for assessment.
  • Compared outcomes between patients treated with HFNC alone and those requiring ventilation.

Main Results:

  • Out of 205 patients, 188 (91.7%) responded successfully to HFNC as the primary treatment.
  • Patients responding to HFNC showed significantly lower respiratory and COMFORT scores and higher SF ratios compared to those needing ventilation (P<0.001).
  • The median time to treatment failure for HFNC was 2 hours, with an air leak complication in only 1% of patients.

Conclusions:

  • High flow nasal cannula therapy is a safe and effective primary respiratory support method for children with respiratory distress.
  • A positive clinical response to HFNC in children is typically observed within the initial hours of treatment.
  • HFNC offers a promising alternative to mechanical ventilation for a significant majority of pediatric patients with respiratory distress.
Abstract

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