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Indications and outcomes of pediatric high flow nasal cannula use in the home setting

David D'Arienzo1,2,3, Liam Sanvido4, Reshma Amin5,6

  • 1Complex Care Program, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Journal of Hospital Medicine
|December 18, 2024
PubMed

Insights

Home high flow nasal cannula (HFNC) use is increasing in pediatric patients for various respiratory issues. This therapy shows few complications but may require escalation to other support methods.

Area of Science:

  • Pediatric Respiratory Medicine
  • Medical Technology Adoption

Background:

  • Home high flow nasal cannula (HFNC) is an emerging respiratory support therapy for children.
  • Understanding its use, indications, and outcomes is crucial for clinical practice.

Purpose of the Study:

  • To describe patient characteristics and clinical outcomes of home HFNC in pediatrics.
  • To evaluate trends in home HFNC initiation from 2013 to 2022.

Main Methods:

  • Retrospective review of pediatric patients on home HFNC (2013-2023) at a Canadian tertiary hospital.
  • Descriptive statistics and Mann-Kendall Trend test were used.

Main Results:

  • 35 pediatric patients initiated on home HFNC between 2013-2023.
  • Initiation significantly increased from 2013-2016 to 2021-2022 (p < .001).
  • Common indications included airway obstruction, CO2 retention, and secretion clearance, often in children with genetic disorders and prior feeding tube use.

Conclusions:

  • Home HFNC use is rising in pediatric care for diverse indications.
  • The therapy appears safe with rare complications, though escalation to CPAP/BiPAP may be needed.
Abstract

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