Format

Send to

Choose Destination
Rev Chil Pediatr. 2015 May-Jun;86(3):173-81. doi: 10.1016/j.rchipe.2015.06.003. Epub 2015 Jul 6.

[High flow nasal cannula in infants: Experience in a critical patient unit].

[Article in Spanish]

Author information

1
Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile. Electronic address: awegnera@gmail.com.
2
Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile.
3
Pediatra, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile.
4
Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile.
5
Enfermera, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile.

Abstract

INTRODUCTION:

The high flow nasal cannula (HFNC) is a method of respiratory support that is increasingly being used in paediatrics due to its results and safety.

OBJECTIVE:

To determine the efficacy of HFNC, as well as to evaluate the factors related to its failure and complications associated with its use in infants.

PATIENTS AND METHOD:

An analysis was performed on the demographic, clinical, blood gas, and radiological data, as well as the complications of patients connected to a HFNC in a critical care unit between June 2012 and September 2014. A comparison was made between the patients who failed and those who responded to HFNC. A failure was considered as the need for further respiratory support during the first 48hours of connection. The Kolmogorov Smirnov, Mann-Whitney U, chi squared and the Exact Fisher test were used, as well as correlations and a binary logistic regression model for P≤.05.

RESULTS:

The study included 109 patients, with a median age and weight: 1 month (0.2-20 months) and 3.7kg (2-10kg); 95 percentile: 3.7 months and 5.7kg, respectively. The most frequent diagnosis and radiological pattern was bronchiolitis (53.2%) and interstitial infiltration (56%). Around 70.6% responded. There was a significant difference between failure and response in the diagnosis (P=.013), radiography (P=018), connection context (P<.0001), pCO2 (median 40.7mmHg [15.4-67 mmHg] versus 47.3mmHg [28.6-71.3mmHg], P=.004) and hours on HFNC (median 60.75hrs [5-621.5 hrs] versus 10.5hrs [1-29 hrs], P<.0001). The OR of the PCO2 ≥ 55mmHg for failure was 2.97 (95% CI; 1.08-8.17; P=.035). No patient died and no complications were recorded.

CONCLUSION:

The percentage success observed was similar to that published. In this sample, the failure of HFNC was only associated with an initial pCO2 ≥ 55mmHg. On there being no complications reported as regards it use, it is considered safe, although a randomised, controlled, multicentre study is required to compare and contrast these results.

KEYWORDS:

Acute respiratory failure; Cánula nasal de alto flujo; Falla respiratoria aguda; High flow nasal cannula; Infants; Lactantes; Oxigenoterapia; Oxygen therapy

PMID:
26363858
DOI:
10.1016/j.rchipe.2015.06.003
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Scientific Electronic Library Online
Loading ...
Support Center