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High-flow nasal cannula in children with asthma exacerbation: A review of current evidence
Ke-Yun Chao1, Yu-Hsuan Chien2, Shu-Chi Mu3
1Department of Respiratory Therapy, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; School of Physical Therapy, Graduate Institute of Rehabilitation Sciences, Chang Gung University, Taoyuan, Taiwan.
Insights
High-flow oxygen therapy (HFNC) offers a promising alternative for pediatric asthma exacerbations. This method provides respiratory support and may overcome limitations of noninvasive positive pressure ventilation (NIPPV).
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Critical Care
Background:
- Asthma is a leading cause of childhood morbidity and hospital admissions due to acute exacerbations.
- Conventional treatment involves oxygen, bronchodilators, and corticosteroids, with escalation to noninvasive positive pressure ventilation (NIPPV) for non-responders.
- Noninvasive positive pressure ventilation (NIPPV) has limitations including patient intolerance due to discomfort and complications.
Purpose of the Study:
- To review the feasibility and current evidence of using high-flow oxygen therapy (HFNC) in children experiencing acute asthma exacerbations.
- To explore variations in HFNC application for pediatric asthma.
Main Methods:
- Review of existing clinical literature and evidence regarding high-flow oxygen therapy (HFNC) in pediatric asthma.
- Analysis of HFNC's mechanism, benefits, and limitations compared to conventional treatments and NIPPV.
Main Results:
- High-flow oxygen therapy (HFNC) provides respiratory support with humidification, demonstrating safety and clinical benefits.
- HFNC may offer an alternative to NIPPV, potentially improving patient tolerance in pediatric asthma exacerbations.
Conclusions:
- High-flow oxygen therapy (HFNC) presents a viable and potentially more tolerable option for managing acute pediatric asthma exacerbations.
- Further research into HFNC's efficacy and specific application protocols in children with asthma is warranted.
Abstract:
Asthma is the commonest obstructive airway disease and the leading cause of morbidity in children. In the pediatric population, acute exacerbations of asthma are a frequent cause of presentations and hospital admissions. An acute asthma exacerbation is potentially life-threatening; it is predominantly treated using conventional oxygen therapy with bronchodilators and systemic corticosteroids. The treatment of those who do not respond to conventional therapy is escalated to noninvasive positive pressure ventilation (NIPPV) before invasive ventilation. Although NIPPV has demonstrated benefits and safety, it still has limitations such as treatment intolerance caused mainly by discomfort and complications. High-flow oxygen therapy administered through a nasal cannula (HFNC) provides respiratory support with adequate airway humidity and has demonstrated safety and benefits in clinical practice. In the present review, we discuss HFNC and variations in HFNC use, focusing on its feasibility and current evidence of using it on children with asthma exacerbations.
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