scholarly journals P0416 / #1612: VENTILATORY SUPPORT WITH HIGH FLOW NASAL CANNULA IN PEDIATRIC PATIENTS WITH RISK FACTORS FOR EXTUBATION FAILURE, EXPERIENCE IN THE PEDIATRIC CRITICAL CARE UNIT.

2021 ◽  
Vol 22 (Supplement 1 3S) ◽  
pp. 216-216
Author(s):  
M. Marquez ◽  
D. Reynaud ◽  
L. Román-Valero
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Critical Care Unit ◽  
Pediatric Patients ◽  
Ventilatory Support ◽  
Extubation Failure ◽  
High Flow ◽  
High Flow Nasal Cannula ◽  
Pediatric Critical Care ◽  
Failure Experience

scholarly journals An Analysis of the Risk Factors for the Failure of Respiratory Support With High-flow Nasal Cannula Oxygen Therapy in Children with Acute Respiratory Dysfunction:a case-control study

2020 ◽  
Author(s):  
jie liu ◽  
Li-na QIAO ◽  
De-yuan LI ◽  
Li-li LUO ◽  
Zhong-qiang LIU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Patients ◽  
Invasive Mechanical Ventilation ◽  
Oxygenation Index ◽  
High Flow ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Failure Group ◽  
Before And After ◽  
Change Trend

Abstract Background:Different causes of acute respiratory insufficiency threaten the lives of pediatric patients, while High-flow nasal cannula oxygen therapy (HFNC) is a new type of non-invasive respiratory support technique that widely used in pediatric intensive care units (PICUs);however, improper use of HFNC is likely to bring adverse consequences to critically ill children.Our objective in this study was to identify the risk factors for the failure of HFNC, that can guide clinicians during managing of HFNC treatment correctly.Methods: Divided the patients into different categories: HFNC success group (237 patients), a 48 h failure group (112 patients), a 24 h failure group (84 patients), and a 2 h failure group (24 patients). The clinical indexes and the change trend in HFNC before and after treatment were dynamically observed in 67 pediatric patients. Risk factors for HFNC failure were determined using multivariate logistic regression analysis.Results:PRISM III score >4 points and PaCO2 >43 mmHg were risk factors for 48 h failure (OR were 4.064, 4.516, P<0.05); PaCO2 >43 mmHg was risk factors for 24 h failure (OR was 3.152, P<0.05); PRISM III score >6.5 points and PaCO2/PaO2 ratio >0.67 were risk factors for 2 h failure (OR were 27.977, 64.366, P<0.05) and the risk of HFNC failure increased more than 5 times when the oxygenation index decreased by >28% after 2 h of HFNC treatment, and the invasive mechanical ventilation time was statistically longer in the patients that upgraded from HFNC to invasive respiratory support than that of patients who received invasive respiratory support directly(P<0.05).Conclusions: The PRISM III score, PaCO2 and PaCO2/PaO2 ratio were risk factors for HFNC failure. Totally the shorter the failure time, the higher the values of the risk factors were, and the higher the failure risk of HFNC was. The change trend in oxygenation index before and after HFNC is a warning factor for early HFNC failure. And early HFNC failure might lead to prolonged invasive mechanical ventilation.

scholarly journals 6 Factors associated with treatment failure of high flow nasal cannula (HFNC) among children with bronchiolitis: a single centre retrospective study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e2-e3
Author(s):  
Michelle D’Alessandro ◽  
Thuva Vanniyasingam ◽  
Ashaka Patel ◽  
Ronish Gupta ◽  
Lucy Giglia ◽  
...  
Keyword(s):  
Critical Care ◽  
Treatment Failure ◽  
High Flow ◽  
Respiratory Support ◽  
Positive Pressure ◽  
High Flow Nasal Cannula ◽  
Patient Factors ◽  
Pediatric Critical Care ◽  
Factors Associated ◽  
Non Invasive

Abstract Background Bronchiolitis is the most common viral lower respiratory tract infection in children under two years of age and is the leading cause of hospital admission for children under the age of one year. Respiratory support for bronchiolitis with high flow nasal cannula (HFNC) is increasingly being used outside of critical care areas and in community hospitals. It is important to understand the patient factors associated with HFNC treatment failure in order to identify which patients are at higher risk for requiring escalation of respiratory support and transfer to a pediatric critical care centre. Objectives The primary objective of this study was to evaluate the patient characteristics that are associated with HFNC treatment failure in bronchiolitis. Design/Methods We completed a retrospective review of patients under 24 months of age with a clinical diagnosis of bronchiolitis admitted to a single tertiary level children’s hospital for supportive management with HFNC between January 2014 and December 2018. Patients who were mechanically ventilated or on non-invasive positive pressure ventilation prior to the initiation of HFNC during their hospital stay were excluded. HFNC treatment failure was the primary endpoint of the study, with treatment failure defined as escalation to non-invasive positive pressure or invasive mechanical ventilation. Multivariable logistic regression analysis was used to identify the patient demographic, clinical, and biochemical parameters associated with HFNC failure. Results Four hundred and thirty-five patient charts were identified, of which 208 patients met inclusion criteria for the study. Of these patients, 61 (29%) were classified as HFNC treatment failures. The likelihood of failing HFNC support was reduced with older age (OR 0.89; 95% CI 0.81, 0.97; p= 0.011) and greater time spent on HFNC (OR 0.94; 95% CI 0.92, 0.96; p&lt;0.001). Patients with a Modified Tal score greater than 5 at 4 hours of HFNC treatment had a greater likelihood of failing HFNC support (OR 2.81; 95% CI 1.04, 7.64; p= 0.042). Conclusion This was the first study to examine predictors of HFNC failure among Canadian children with bronchiolitis. We found that patient age, time spent on HFNC, and severity of bronchiolitis as defined using a Modified Tal score were associated with HFNC failure. These patient factors should be considered when initiating HFNC for bronchiolitis, and may identify patients at risk for escalation of respiratory support, warranting earlier referral to pediatric critical care centres.

scholarly journals High-Flow Nasal Cannula Utilization in Pediatric Critical Care

2017 ◽  
Vol 62 (8) ◽  
pp. 1023-1029 ◽  
Author(s):  
Kristen D Coletti ◽  
Dayanand N Bagdure ◽  
Linda K Walker ◽  
Kenneth E Remy ◽  
Jason W Custer
Keyword(s):  
Critical Care ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Pediatric Critical Care

scholarly journals Standardized Extubation and High Flow Nasal Cannula Training Program for Pediatric Critical Care Providers in Lima, Peru

MedEdPORTAL ◽  
2020 ◽  
Vol 16 (1) ◽  
pp. 10937
Author(s):  
Laura E. Ellington ◽  
Rosario Becerra Velásquez ◽  
José Tantaleán da Fieno ◽  
Gabriela Mallma Arrescurrenaga ◽  
Katie R. Nielsen
Keyword(s):  
Critical Care ◽  
Training Program ◽  
High Flow ◽  
Nasal Cannula ◽  
Care Providers ◽  
High Flow Nasal Cannula ◽  
Pediatric Critical Care

scholarly journals High-flow nasal oxygen therapy in acute respiratory failure

2018 ◽  
Vol 4 (3) ◽  
Author(s):  
Raffaele Scala
Keyword(s):  
Respiratory Diseases ◽  
Oxygen Therapy ◽  
Extubation Failure ◽  
High Flow ◽  
High Flow Nasal Cannula ◽  
Clinical Advantage ◽  
End Stage ◽  
Respiratory Assistance ◽  
Spontaneously Breathing ◽  
Selection Of

High-flow nasal cannula (HFNC) is a new effective device, which is able to deliver oxygen-therapy at a reliable FiO2 but also a certain amount of respiratory assistance; however HFNC could not be defined as a mechanical ventilator. The main physiologic advantage as compared to conventional oxygen therapy (COT) is the capability of HFNC to meet the increased ventilator demand in patients with respiratory distress and therefore reduce the amount of respiratory muscle’s workload. The main clinical advantage over both COT and noninvasive ventilation (NIV) is the greater comfort and acceptability reported by patients. So far there are several indications for HFNC use both in and outside ICU especially for milder hypoxemic spontaneously breathing patients and prevention of extubation failure in intubated patients, as well as palliative care in end stage neoplastic and nonneoplastic respiratory diseases. A large proportion of potential HFNC candidates belongs to advanced age people. Caution should be taken in the selection of the patients, monitoring, escalating treatment and setting of aplication.

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