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Med Intensiva. 2017 Oct;41(7):418-424. doi: 10.1016/j.medin.2017.01.001. Epub 2017 Feb 16.

High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study.

[Article in English, Spanish]

Author information

1
PICU, Cruces University Hospital, Plaza de Cruces s/n, Barakaldo 48903, Spain. Electronic address: fco.javier.pilarorive@osakidetza.eus.
2
PICU, Hospital Universitari i Politècnic La Fe de Valencia, Avinguda de Fernando Abril Martorell, 106, 46026 Valencia, Spain.
3
PICU, Cruces University Hospital, Plaza de Cruces s/n, Barakaldo 48903, Spain.

Abstract

INTRODUCTION:

The present study describes our experience with the high-flow humidified nasal cannula (HFNC) versus non-invasive ventilation (NIV) in children with severe acute asthma exacerbation (SA).

METHODS:

An observational study of a retrospective cohort of 42 children with SA admitted to a Pediatric Intensive Care Unit (PICU) for non-invasive respiratory support was made. The primary outcome measure was failure of initial respiratory support (need to escalate from HFNC to NIV or from NIV to invasive ventilation). Secondary outcome measures were the duration of respiratory support and PICU length of stay (LOS).

RESULTS:

Forty-two children met the inclusion criteria. Twenty (47.6%) received HFNC and 22 (52.3%) NIV as initial respiratory support. There were no treatment failures in the NIV group. However, 8 children (40%) in the HFNC group required escalation to NIV. The PICU LOS was similar in both the NIV and HFNC groups. However, on considering the HFNC failure subgroup, the median length of respiratory support was 3-fold longer (63h) and the PICU LOS was also longer compared with the rest of subjects exhibiting treatment success.

CONCLUSIONS:

Despite its obvious limitations, this observational study could suggest that HFNC in some subjects with SA may delay NIV support and potentially cause longer respiratory support, and longer PICU LOS.

KEYWORDS:

Asthma exacerbation; Children; Critical care; Cuidados críticos; Duración de la estancia; Estatus asmático; High-flow nasal cannula; Length of stay; Niños; Non-invasive ventilation; Oxigenoterapia de alto flujo; Ventilación no invasiva

PMID:
28216104
DOI:
10.1016/j.medin.2017.01.001
[Indexed for MEDLINE]
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