scholarly journals A randomised trial of high-flow nasal cannula in infants with moderate bronchiolitis

2020 ◽  
Vol 56 (1) ◽  
pp. 1901926 ◽  
Author(s):  
Philippe Durand ◽  
Tamma Guiddir ◽  
Christèle Kyheng ◽  
Florence Blanc ◽  
Olivier Vignaud ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Controlled Trial ◽  
Randomised Trial ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Control Group ◽  
Study Group ◽  
High Flow Nasal Cannula ◽  
Significant Difference

BackgroundThe objective was to determine whether high-flow nasal cannula (HFNC), a promising respiratory support in infant bronchiolitis, could reduce the proportion of treatment failure requiring escalation of care.MethodsIn this randomised controlled trial, we assigned infants aged <6 months who had moderate bronchiolitis to receive either HFNC at 3 L·kg−1·min−1 or standard oxygen therapy. Crossover was not allowed. The primary outcome was the proportion of patients in treatment failure requiring escalation of care (mostly noninvasive ventilation) within 7 days following randomisation. Secondary outcomes included rates of transfer to the paediatric intensive care unit (PICU), oxygen, number of artificial nutritional support-free days and adverse events.ResultsThe analyses included 268 patients among the 2621 infants assessed for inclusion during two consecutive seasons in 17 French paediatric emergency departments. The percentage of infants in treatment failure was 14% (19 out of 133) in the study group, compared to 20% (27 out of 135) in the control group (OR 0.66, 95% CI 0.35–1.26; p=0.21). HFNC did not reduce the risk of admission to PICU (21 (15%) out of 133 in the study group versus 26 (19%) out of 135 in the control group) (OR 0.78, 95% CI 0.41–1.41; p=0.45). The main reason for treatment failure was the worsening of modified Wood clinical asthma score (m-WCAS). Short-term assessment of respiratory status showed a significant difference for m-WCAS and respiratory rate in favour of HFNC. Three pneumothoraces were reported in the study group.ConclusionsIn patients with moderate bronchiolitis, there was no evidence of lower rate of escalating respiratory support among those receiving HFNC therapy.

A study of heated, humidified high flow nasal cannula as an initial respiratory support in preterm neonates

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham A Awad ◽  
Rania A El-Farrash ◽  
Dina M Shinkar ◽  
Yasmin A. F Aly ◽  
Nanies Soliman ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Treatment Failure ◽  
Preterm Infants ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Invasive Ventilation ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Significant Difference

Abstract Background There is an increased use of heated, humidified, high-flow nasal cannula (HHFNC) as a non-invasive respiratory support. Yet, there are limited data that compares it with nasal continuous positive airway pressure (nCPAP) as regard the efficacy & outcome when used for initial treatment in preterm infants with respiratory distress syndrome (RDS) shortly postnatal. Method A prospective study conducted aiming to evaluate the effectiveness & outcome of HHFNC compared to nCPAP for the treatment of preterm infants with RDS. Preterms &lt; 35 weeks of gestational age with symptoms and signs of RDS early after birth were randomized to HHFNC or nCPAP. Primary outcome was the incidence of treatment failure (defined as need for upgrading to noninvasive positive pressure ventilation or invasive ventilation). Results Analysis of the randomly allocated infants to HHFNC and nCPAP showed no significant difference in treatment failure (P &gt; 0.05). There was also no significant difference (P &gt; 0.05) among groups as regard mortality, sepsis, necrotizing enterocolitis, incidence of interventricular hemorrhage and bronchopulmonary dysplasia. Conclusion This indicates that HHFNC may be used as an equally effective and safe method of non-invasive ventilation when compared to nCPAP for initial respiratory support in preterm infants with respiratory distress.

High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis

2019 ◽  
Vol 104 (6) ◽  
pp. 564-576 ◽  
Author(s):  
Jilei Lin ◽  
Yin Zhang ◽  
Limei Xiong ◽  
Sha Liu ◽  
Caihui Gong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Low Income ◽  
High Flow ◽  
Nasal Cannula ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
High Flow Nasal Cannula ◽  
Respiratory Management ◽  
Significant Difference

ObjectivesTo review the effects and safety of high-flow nasal cannula (HFNC) for bronchiolitis.MethodsSix electronic databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, CQ VIP Database and Wanfang Data were searched from their inception to 1 June 2018. Randomised controlled trials (RCTs) which investigated the effects of HFNC versus other forms of oxygen therapies for bronchiolitis were included.ResultsNine RCTs with 2121 children met the eligibility criteria. There was no significant difference in length of stay in hospital (LOS), length of oxygen supplementation (LOO), transfer to intensive care unit, incidence of intubation, respiratory rate, SpO2 and adverse events in HFNC group compared with standard oxygen therapy (SOT) and nasal continuous positive airway pressure (nCPAP) groups. A significant reduction of the incidence of treatment failure (risk ratio (RR) 0.50, 95% CI 0.40 to 0.62, p<0.01) was observed in HFNC group compared with SOT group, but there was a significant increase of the incidence of treatment failure (RR 1.61, 95% CI 1.06 to 2.42, p0.02) in HFNC group compared with nCPAP group. In subgroup analysis, LOS was significantly decreased in HFNC group compared with SOT group in low-income and middle-income countries.ConclusionThe systematic review suggests HFNC is safe as an initial respiratory management, but the evidence is still lacking to show benefits for children with bronchiolitis compared with SOT or nCPAP.

scholarly journals The Role of Heated Humidified High-flow Nasal Cannula as Noninvasive Respiratory Support in Neonates

2017 ◽  
Vol 58 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Ke-Yun Chao ◽  
Yi-Ling Chen ◽  
Li-Yi Tsai ◽  
Yu-Hsuan Chien ◽  
Shu-Chi Mu
Keyword(s):  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula

scholarly journals Effectiveness of Antipyretic with Tepid Sponging Versus Antipyretic Alone in Febrile Children: A Randomized Controlled Trial

2018 ◽  
Vol 37 (2) ◽  
pp. 129-133
Author(s):  
Chetak Kadbasal Basavaraj ◽  
Shyamala Gowri Pocha ◽  
Ravi Mandyam Dhati
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Control Group ◽  
Study Group ◽  
Axillary Temperature ◽  
Medical College ◽  
Randomized Controlled ◽  
Significant Difference

Introduction: Fever is the most common presenting complain for which children are brought to the paediatrician.Physical methods are widely used in treating febrile children, tepid sponging being commonly practiced in hospitals along with antipyretics. The objectives of this study were to compare the effectiveness of tepid sponging and antipyretic drug versus antipyretic drug alone in febrile children.Material and Methods: This was a Randomized controlled trial done in JSS Medical College and Hospital. All children under the age of 6 months to 12 years, admitted with axillary temperature of >99oF were included in the study. A total of 500 children were included over two years study period. Children with recorded axillary temperature of >990F were randomized into control and study group by computer generated randomisation. Children in the control group received only paracetamol (15mg/kg) at 5 minutes and combined group received paracetamol and tepid sponging at five minutes. Axillary temperature was monitored every 15 minutes for a period of 2 hours in both the groups.Results: There is no significant difference in reduction of temperature between the two groups by the end of two hours. Children in combined group had a higher level of discomfort than those in only antipyretic group.Conclusion: Tepid sponging does not add to the efficacy of paracetamol in antipyresis and that addition of tepid sponging to antipyretic, results in additional discomfort for the child. This study, therefore, endorses the view that antipyretic alone without tepid sponging should be the modality of therapy in children with fever.  

Sign in / Sign up

Export Citation Format

Share Document