scholarly journals Comparison of high flow oxygen therapy in children with respiratory distress due to bronchiolitis and pneumonia

2021 ◽  
Author(s):  
Uday S. Surabhi ◽  
Gangasamudra Veerappa Basavaraja ◽  
Maaz Ahmed ◽  
Sujith Kumar Tummala
Keyword(s):  
Respiratory Distress ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
High Flow Oxygen ◽  
Clinical Stabilization

Background: Respiratory support through high flow nasal cannula (HFNC) therapy has emerged as a new method to provide respiratory support with bronchiolitis. Aim was to study outcome of HFNC therapy in children with bronchiolitis and pneumonia.Methods: The study was a prospective observational study involving children admitted to pediatric intensive care unit with respiratory distress (RD) in the age group of 1 month to 6 years over a period of 3 months (February 2017 till April 2017). Severity was assessed by clinical respiratory score (CRS). Children with RD were initiated with high flow nasal cannula. During treatment various parameters including CRS were documented at baseline and at 15 min and then hourly in a carefully designed performa. The primary outcome was failure of HFNC and need for ventilation.Results: Sixty children were included in the study of which 22 (37%) were in the bronchiolitis group and 38 (63%) were in the pneumonia group. 38 children presented with severe RD and 19 children with moderate RD. There was significant decrease in heart rate (HR) (20%), respiratory rate (RR) (20%) and in CRS within 1 hour of HFNC with a clinical stabilization within 24 hours in 16 cases (27%), 24-48 hours in 35 cases (58%) and >48 hours in 5 (8%) cases. Therapy was successful in 55 (92%), and failed in 5 (8%).Conclusions: HFNC has better outcome in children with RD due to acute bronchiolitis when compared to pneumonia. HFNC can be safely commenced in RD in critically ill child with monitoring.

Heated Humidified High-Flow Nasal Cannula for Preterm Infants: An Updated Systematic Review and Meta-analysis

2019 ◽  
Vol 35 (4) ◽  
pp. 298-306 ◽  
Author(s):  
Nigel Fleeman ◽  
Yenal Dundar ◽  
Prakesh S Shah ◽  
Ben NJ Shaw
Keyword(s):  
Systematic Review ◽  
Preterm Infants ◽  
Primary Outcome ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Cochrane Library ◽  
High Flow Nasal Cannula ◽  
Safe Alternative

AbstractBackgroundHeated humidified high-flow nasal cannula (HHHFNC) is gaining popularity as a mode of respiratory support. We updated a systematic review and meta-analyses examining the efficacy and safety of HHHFNC compared with standard treatments for preterm infants. The primary outcome was the need for reintubation for preterm infants following mechanical ventilation (post-extubation analysis) or need for intubation for preterm infants not previously intubated (analysis of primary respiratory support)MethodsWe searched PubMed, MEDLINE, Embase, and the Cochrane Library for randomized controlled trials (RCTs) of HHHFNC versus standard treatments. Meta-analysis was conducted using Review Manager 5.3.ResultsThe post-extubation analysis included ten RCTs (n = 1,201), and the analysis of primary respiratory support included ten RCTs (n = 1,676). There were no statistically significant differences for outcomes measuring efficacy, including the primary outcome. There were statistically significant differences favoring HHHFNC versus nasal cannula positive airway pressure (NCPAP) for air leak (post-extubation, risk ratio [RR] 0.29, 95 percent confidence interval [CI] 0.11 to 0.76, I2 = 0) and nasal trauma (post-extubation: 0.35, 95 percent CI 0.27 to 0.46, I2 = 5 percent; primary respiratory support: RR 0.52, 95 percent CI 0.37 to 0.74; I2 = 27 percent). Studies, particularly those of primary respiratory support, included very few preterm infants with gestational age (GA) <28 weeks.ConclusionsHHHFNC may offer an efficacious and safe alternative to NCPAP for some infants but evidence is lacking for preterm infants with GA ≤28 weeks.

scholarly journals COVID-19 pneumonia successfully managed with high-flow nasal cannula in a 15-year-old boy

2021 ◽  
Vol 14 (4) ◽  
pp. e239682
Author(s):  
GAP van Gorp ◽  
PJLT Sanders ◽  
DA van Waardenburg ◽  
Monique Engel
Keyword(s):  
Work Of Breathing ◽  
Oxygen Demand ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Lower Airway ◽  
Nasopharyngeal Swab ◽  
High Flow Nasal Cannula ◽  
Amoxicillin Clavulanic Acid

We report an otherwise healthy, fully immunised 15-year-old boy who was transferred to our Pediatric intensive care unit with 4 days of fever, dry cough, increased work of breathing and impending respiratory failure. Two days prior, amoxicillin/clavulanic acid was prescribed for lower airway symptoms resembling pneumonia. PCR of the nasopharyngeal swab revealed an active COVID-19 infection (Ct 19). The CT scan showed significant ground-glass opacities highly associated with COVID-19 (COVID-19 reporting and data system 4). Antibiotics were continued and chloroquine was given for 5 days. High-flow nasal cannula (HFNC) was started as respiratory support therapy with rapid decrease of tachypnoea and oxygen demand. HFNC was successfully stopped after 7 days. The patient made full clinical recovery. This case illustrates HFNC as a successful respiratory support therapy in a paediatric patient with an active COVID-19 pneumonia.

scholarly journals High flow nasal cannula versus non-invasive ventilation in severe asthma: two years prospective observational study.

2021 ◽  
Author(s):  
Carolina Solé-Delgado ◽  
Alberto García-Salido ◽  
Ainhoa Gochi-Valdovinos ◽  
Anthony González-Brabin ◽  
Maria García ◽  
...  
Keyword(s):  
Observational Study ◽  
Severe Asthma ◽  
Prospective Observational Study ◽  
Invasive Mechanical Ventilation ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Respiratory Management

Background: in recent years, High Flow Nasal Cannula (HFNC) has been considered an alternative to non-invasive mechanical ventilation (NIMV) in severe asthma respiratory management in children. Objective: to describe the use of HFNC in children with severe asthma admitted to pediatric critical care unit (PICU). To compare its clinical characteristic and evolution with those receiving NIMV or other respiratory support. Methods: prospective observational study done in children admitted to PICU with severe asthma (October 2017 to October 2019). Data collected: epidemiological, clinical, respiratory support, thorax x-ray, pharmacological treatments and days of admission. Patients were divided into groups: 1) Only HFNC 2) HFNC and NIMV, and 3) Only NIMV. Results: Seventy-six patients included, 39 girls. The median age was two years and one month (range 160). The median pulmonary score was 5 (range 7). PICU admission lengths a median of 3 days (range 9), hospital 6 days (range 23). There were no epidemiological or clinical differences between groups. Children with only HNFC showed a shorter time of PICU days (p 0,025) and none of them required NIMV. In the group receiving both modalities, NIMV was used first and then HFNC in all cases. Children with HFNC showed higher SaO2/FiO2 ratio (p=0,025) and lower PCO2 level (p=0,032). There were no deaths. Conclusions: in our study the HFNC did not require escalation to NIMV and did not increase the length of PICU or hospital days. Normal initial blood gases and absence of high oxygen requirements were useful to select responders to HNFC.

scholarly journals The Effect of the Treatment with Heated Humidified High-Flow Nasal Cannula on Neonatal Respiratory Distress Syndrome in China: A Single-Center Experience

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ge Zheng ◽  
Xiao-qiu Huang ◽  
Hui-hui Zhao ◽  
Guo-Xing Jin ◽  
Bin Wang
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Neonatal Respiratory Distress

Background. Noninvasive respiratory support is considered the optimal method of providing assistance to preterm babies with breathing problems, including nasal continuous positive airway pressure (NCPAP) and humidified high flow nasal cannula (HHHFNC). The evidence of the efficacy and safety of HHHFNC used as the primary respiratory support for respiratory distress syndrome (RDS) is insufficient in low- and middle-income countries. Objective. To investigate the effect of heated humidified high flow nasal cannula on neonatal respiratory distress syndrome compared with nasal continuous positive airway pressure. Methods. An observational cross-sectional study was performed at a tertiary neonatal intensive care unit in suburban Wenzhou, China, in the period between January 2014 and December 2015. Results. A total of 128 infants were enrolled in the study: 65 in the HHHFNC group and 63 in the NCPAP group. The respiratory support with HHHFNC was similar to that with NCPAP with regard to the primary outcome. There is no significant difference between two groups in secondary outcomes. Comparing with NCPAP group, the incidence of nasal damage was lower in HHHFNC group. Conclusions. HHHFNC is an effective and well-tolerated strategy as the primary treatment of mild to moderate RDS in preterm infants older than 28 weeks of GA.

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.

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