Related Experiment Video
Updated: Aug 16, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
High flow nasal cannula therapy in the pediatric home setting
Shay Ehrlich1, Inbal Golan Tripto2,3, Moran Lavie4,5
1Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
Insights
Home high-flow nasal cannula (HFNC) therapy is safe and effective for children with various conditions, improving weight gain and reducing hospitalizations. Parents reported high satisfaction and would recommend this treatment.
Area of Science:
- Pediatric respiratory care
- Home healthcare innovations
- Noninvasive respiratory support
Background:
- High-flow nasal cannula (HFNC) therapy is increasingly adopted in pediatric acute care due to better tolerance than noninvasive ventilation (NIV).
- HFNC is approved for domestic use in Israel, necessitating an evaluation of its real-world application.
Purpose of the Study:
- To describe the indications for home HFNC therapy in children.
- To evaluate the efficacy, safety, and tolerability of domestic HFNC.
- To assess parental satisfaction with home HFNC therapy.
Main Methods:
- A retrospective study involving 75 children treated with home HFNC across three pediatric centers.
- Data collection included demographics, indications for use, and hospitalization days before and after HFNC initiation.
- Safety, tolerability, and parental satisfaction were assessed via a standardized telephone questionnaire.
Main Results:
- The median age for initiating home HFNC was 8.3 months, with common indications including obstructive sleep apnea, airway malacia, and chronic lung disease.
- Home HFNC use was associated with a significant improvement in weight standard deviation score (p < 0.001) and a reduction in hospital admission days (p < 0.008).
- Parental satisfaction was high (median score 5/5), with 83% recommending home HFNC, and no serious adverse events were reported.
Conclusions:
- Domestic HFNC therapy is a safe and well-tolerated option for pediatric patients with diverse respiratory needs.
- The implementation of home HFNC is linked to enhanced weight gain, decreased hospitalizations, and high levels of parental satisfaction.
- Further research is needed to identify specific pediatric subgroups that would most benefit from HFNC compared to traditional NIV methods.
Background:
High-flow nasal cannula (HFNC) therapy may be better tolerated than traditional noninvasive ventilation (NIV) and is rapidly gaining acceptance in pediatric acute care. In Israel, HFNC is approved for domestic use. We aim to describe its indications, efficacy, parental satisfaction, and safety.
Methods:
Retrospective study of children treated with home HFNC therapy in three pediatric centers. Data included demographic parameters, indication of use, weight and days of hospitalization before and after initiation. Safety, tolerability, and parental satisfaction were assessed via standardized telephone questionnaire.
Results:
Median (interquartile range [IQR]) age of initiating home HFNC in 75 children was 8.3 (2.2, 29.6) months. Indications were obstructive sleep apnea (33; 44%), airway malacia (19; 25%), chronic lung disease (15; 20%), neuromuscular disease (4; 5%), and postextubation support (4; 5%). Weight standard deviation score rose from -2.3 pre-HFNC to -1.7 at 6.7 months post-HFNC initiation, p < 0.001. Hospital admission days during the 2 months pre- versus post-HFNC initiation were 22 (5.5, 60) and 5 (0, 14.7) respectively, p < 0.008. Median (IQR) parental satisfaction score was 5/5 (4, 5). Fifty of 60 (83%) respondents would recommend home HFNC to other families in a similar situation. There were no serious adverse events.
Conclusion:
In our population, domestic HFNC appeared safe and well tolerated for a variety of indications. Its introduction was associated with improved weight gain, fewer hospitalization days and high parental satisfaction. Further work is required to characterize groups of children most likely to benefit from HFNC, as opposed to traditional modes of NIV.
Related Concept Videos
01:29Administering Oxygen by Nasal Cannula
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...
01:26Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes: