Factors associated to high-flow nasal cannula treatment failure in pediatric patients with respiratory failure in two pediatric intensive care units at high altitude

2021 ◽  
Vol 45 (4) ◽  
pp. 195-204
Author(s):  
P. Vásquez-Hoyos ◽  
A. Jiménez-Chaves ◽  
M. Tovar-Velásquez ◽  
R. Albor-Ortega ◽  
M. Palencia ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Treatment Failure ◽  
High Altitude ◽  
Intensive Care Units ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
High Flow Nasal Cannula ◽  
Factors Associated

scholarly journals Factors associated with interhospital transfer of children with respiratory failure from level II to level I pediatric intensive care units

2015 ◽  
Vol 30 (5) ◽  
pp. 1080-1084 ◽  
Author(s):  
Folafoluwa O. Odetola ◽  
Sarah J. Clark ◽  
James G. Gurney ◽  
Janet E. Donohue ◽  
Achamyeleh Gebremariam ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
Pediatric Intensive Care Units ◽  
Factors Associated ◽  
Interhospital Transfer ◽  
Level Ii ◽  
Level I

scholarly journals Title High Flow Nasal cannula oxygen therapy in a general pediatric (non-intensive care) setting

2019 ◽  
Author(s):  
Louise Kooiman ◽  
Roelien Reimink ◽  
Veerle Langenhorst ◽  
Paul Brand ◽  
Jolita Bekhof
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Treatment Failure ◽  
Hospital Admissions ◽  
Work Of Breathing ◽  
High Flow ◽  
Nasal Cannula ◽  
Early Warning Score ◽  
High Flow Nasal Cannula ◽  
Vital Functions

Abstract Background: High flow nasal cannula therapy (HFNC) is being used increasingly for oxygen delivery in children with impending respiratory failure, however solid evidence of its effectiveness is sparse. Moreover, data on safety regarding its use outside of the Pediatric Intensive Care Unit (PICU), with flowrates exceeding 1 L/kg is lacking. Methods: Retrospective chart review at the pediatric ward of Isala, a general teaching hospital in Zwolle, The Netherlands, 100 km away from the nearest PICU. All children <18 years with impending respiratory failure treated with HFNC between January 2015 and May 2016 were included. A flowrate of 2 L/kg/minute for the first 10 kg was used; with 0.5 L/kg for every kg >10 kg and a maximum of 50 L/min. A pediatric early warning score (PEWS) comprising vital functions and work of breathing (0-28 points) was used to assess severity of respiratory distress. Treatment failure was defined as referral to the PICU. Results: In the 16-month study period HFNC was used during 41 hospital admissions in 39 patients (64.1% male), median age 6.3 months (interquartile range, IQR 3–20.6). Median (IQR) PEWS at the start of HFNC was 8.5 (7–10). Patients were diagnosed with bronchiolitis (70.7%), pneumonia (24.4%) or asthma (4.9%). In 18 cases (43.9%) HFNC failed, with referral to a PICU. No clinical variables (age, comorbidity, PEWS at admission or start of HFNC) nor improvement of the PEWS after 2 hours of HFNC were associated with treatment failure. We found no association between treatment failure and the start of HFNC at an earlier stage or at lower PEWS (odds ratio 1.03; 95% confidence interval 0.82-1.30; p=0.80). There were no safety issues, no cases with air leak or other complications. Conclusions: This small study suggests that HFNC can be safely used and initiated in a general pediatric department. We were unable to find clinical factors that predicted HFNC success. We recommend not to restrict evaluation of the effect of HFNC in studies to short-term (2 hours), but also after longer duration, at least 24 hours.

Use of high-flow nasal cannula in infants with viral bronchiolitis outside pediatric intensive care units

2019 ◽  
Vol 178 (10) ◽  
pp. 1479-1484 ◽  
Author(s):  
Mélanie Panciatici ◽  
Candice Fabre ◽  
Sophie Tardieu ◽  
Emilie Sauvaget ◽  
Marion Dequin ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Pediatric Intensive Care Units

scholarly journals Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

2021 ◽  
Author(s):  
Rosalie S. Linssen ◽  
◽  
Reinout A. Bem ◽  
Berber Kapitein ◽  
Katrien Oude Rengerink ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
The Netherlands ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Syncytial Virus

AbstractRespiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known:• RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission.• The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New:• The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies.• There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.

scholarly journals High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure

2021 ◽  
Vol 10 (16) ◽  
pp. 3515
Author(s):  
Arthur Hacquin ◽  
Marie Perret ◽  
Patrick Manckoundia ◽  
Philippe Bonniaud ◽  
Guillaume Beltramo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Intensive Care Units ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
High Concentration ◽  
Geriatric Unit ◽  
Older Inpatients

We aimed to compare the mortality and comfort associated with high-flow nasal cannula oxygenation (HFNCO) and high-concentration mask (HCM) in older SARS-CoV-2 infected patients who were hospitalized in non-intensive care units. In this retrospective cohort study, we included all consecutive patients aged 75 years and older who were hospitalized for acute respiratory failure (ARF) in either an acute geriatric unit or an acute pulmonary care unit, and tested positive for SARS-CoV-2. We compared the in-hospital prognosis between patients treated with HFNCO and patients treated with HCM. To account for confounders, we created a propensity score for HFNCO, and stabilizing inverse probability of treatment weighting (SIPTW) was applied. From March 2020 to January 2021, 67 patients (median age 87 years, 41 men) were hospitalized with SARS-CoV-2-related ARF, of whom 41 (61%) received HFNCO and 26 (39%) did not. Age and comorbidities did not significantly differ in the two groups, whereas clinical presentation was more severe in the HFNCO group (NEW2 score: 8 (5–11) vs. 7 (5–8), p = 0.02, and Sp02/Fi02: 88 (98–120) vs. 117 (114–148), p = 0.03). Seven (17%) vs. two (5%) patients survived at 30 days in the HFNCO and HCM group, respectively. Overall, after SIPTW, HFNCO was significantly associated with greater survival (adjusted hazard ratio (AHR) 0.57, 95% CI 0.33–0.99; p = 0.04). HFNCO use was associated with a lower need for morphine (AHR 0.39, 95% CI 0.21–0.71; p = 0.005), but not for midazolam (AHR 0.66, 95% CI 0.37–1.19; p = 0.17). In conclusion, HFNCO use in non-intensive care units may reduce mortality and discomfort in older inpatients with SARS-CoV-2-related ARF.

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