Osman BÜYÜKŞEN, Süleyman BAYRAKTAR, Murat ELEVLİ

Çocuk Yoğun Bakım Ünitesinde Yüksek Akımlı Nazal Kanül Oksijen Tedavisi Alan Has-taların Klinik ve Epidemiyolojik Özelliklerinin Değerlendirilmesi

Amaç: Akut solunum yetmezliğinde solunum desteği yöntemlerinden biri, giderek kullanım sıklığı artan yüksek akımlı nazal kanül oksijen tedavisidir (YANKOT). Bu çalışmada, solunum yetmezliği nedeniyle çocuk yoğun bakım ünitesine yatırılan ve YANKOT uygulanan hastaların retrospektif olarak değerlendirilmesi amaçlandı. Araçlar ve Yöntem: Çalışma retrospektif olarak, Ocak 2015- Aralık 2017 tarihleri arasında çocuk yoğun bakım ünitesinde yatan ve YANKOT uygulanmış 104 hasta alınarak yapıldı. Bulgular: Çalışmaya katılan hastaların yaşlarının medyan değeri 5 ay olarak saptandı. En sık yatış endikasyonu %97.1 oranında alt hava yolu hastalığıydı ve hastaların %52.9’unda tip 1 solunum yetmezliği saptandı. Çocuk yoğun bakımdaki yatış süresi medyan değeri 7 gün iken, YANKOT uygulama süresi medyan değeri 48 saat olarak saptandı. YANKOT alırken entübe olan hastalarda (%28.8) kronik hastalık ve kronik akciğer hastalığı entübe olmayanlara göre belirgin olarak yüksekti (p=0.001, p=0.033, sırasıyla). Hastalarda komplikasyon olarak %8.7’sinde nazal bölgede cilt hasarı, %1.9’unda pnömotoraks geliştiği saptandı. Çocuk yoğun bakım ünitesine yatıp YANKOT alırken ölen hastalarda kronik hastalık ve konjenital kalp hastalığı oran-ları hayatta kalan hastalara göre belirgin olarak yüksekti (p=0.043, p=0.003, sırasıyla).Sonuç: Son yıllarda çocuklarda solunum yetmezliği tedavisinde kullanılmaya başlanan YANKOT’un sonuçları genellikle yüz güldürücüdür. Bununla birlikte bu yeni yöntemde komplikasyonların gelişebilmesi nedeniyle uygulama süresince yakın izlem gerekmektedir.

Anahtar Kelimeler:

çocuk, çocuk yoğun bakım ünitesi, solunum yetersizliği, oksijen tedavisi

Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit

Purpose: One of the respiratory supports in acute respiratory failure (ARF) is high-flow nasal cannula (HFNC) oxygen therapy, which is being increasingly used in this study. We aimed to evaluate the patients with ARF who received HFNC oxygen therapy in the pediatric intensive care unit (ICU).Materials and Methods: The study was done retrospectively in 104 patients who were admitted to the pediatric ICU and received HFNC oxygen therapy between January 2015 and December 2017. Results: The median age of the patients participating in the study was 5 months. The most common cause of hospitalization was lower respiratory disease (97.1%), and 52.9% of the patients had type 1 respiratory failure. The median length of stay in the pediatric ICU was 7 days, while the median duration of HFNC oxygen therapy was 48 hours. In patients who were intubated during HFNC oxygen therapy (28.8%), the proportions of having a chronic disease and chronic lung disease were significantly higher than those who were not intubated (p=0.001, p=0.033, respectively). In terms of complications, nasal skin damage (8.7%) and pneumothorax (1.9%) were developed. The proportions of chronic diseases and congenital heart disease of the patients who were admitted to pediatric ICU and died after HFNC oxygen therapy were significantly higher than the survivors (p=0.043, p=0.003, respectively).Conclusion: The results of HFNC oxygen therapy, which is being increasingly used in the treatment of respiratory failure in children, are generally satisfactory. However, due to possible complications, close monitoring is required during the application.

Keywords:

child, Pediatric intensive care unit, Respiratory failure, oxygen therapy,

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