High Flow Nasal Oxygen Therapy in Pediatric Intensive Care Unit

Objective: Acute respiratory failure is the most common reason for hospitalization to pediatric intensive care units. Invasive and non-invasive respiratory support methods are used for the treatment of patients with acute respiratory failure findings. The aim of this study is to evaluate the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in pediatric intensive care. Method: This retrospective observational study was conducted between February 2017 and January 2018 in pediatric intensive care unit of Bahçeşehir Liv Hospital, İstinye University Faculty of Medicine. Patients aged between 1 month and 18 years, who received HFNC oxygen therapy for respiratory support in the pediatric intensive care unit, were included in the study. Results: HFNC therapy was received by 67 patients during one year of the study. 58.2% of the patients were male. The mean age of the patients was 37.2 months (R, 1-192), and their average body weight was 11.8 kg (R, 2.8-50). 65.7% of patients had an underlying disease. The most underlying disease was neurological disease with the rate of 35.8%. 94% of our patients received HFNC therapy due to acute respiratory failure, 3% due to acute heart failure and 3% due to shock. 40.3% of our patients received HFNC therapy due to pneumonia, 16.4% due to bronchopneumonia, 14.9% due to bronchiolitis, and 11.9% due to postextubation. 71.6% of patients receiving HFNC therapy improved their clinical findings without intubation. After HFNC therapy, there was a statistically considerable decrease in the respiratory rate, heart rate and retraction of the patients. HFNC therapy failure rates were statistically significantly higher in patients with underlying disease and especially in those with cardiac disease. Conclusion: As a result, it is known that HFNC therapy has been used effectively in children in recent years, and it provides improvement in vital findings and blood gas parameters. In our study, 71.6% of our patients benefited from HFNC therapy.

Çocuk Yoğun Bakım Ünitesinde Yüksek Akışlı Nazal Oksijen Tedavisi

Amaç: Çocuk yoğun bakım ünitelerine yatışın en sık nedeni akut solunum yetmezliğidir. Akut solunum yetmezliği bulguları olan hastalara tedavi amaçlı invazif ve non-invazif solunum destek yöntemleri kullanılmaktadır. Bu çalışmanın amacı çocuk yoğun bakımda yüksek akışlı nazal kanül oksijen (YANKO) tedavisinin etkinliğini değerlendirmektir. Yöntem: Bu retrospektif gözlemsel çalışma, Şubat 2017 ile Ocak 2018 tarihleri arasında İstinye Üniversitesi Tıp Fakültesi, Bahçeşehir Liv Hastanesi, Çocuk Yoğun Bakım Ünitesi’nde gerçekleştirilmiştir. Bir ay ile 18 yaş arasında çocuk yoğun bakım ünitesinde solunum desteği amacıyla yüksek akışlı nazal kanül oksijen tedavisi alan hastalar çalışmaya alındı. Bulgular: Bir yıllık çalışma süresi içerisinde 67 hastamız YANKO tedavisi aldı. Hastaların %58,2’si erkekti. Hastaların ortalama yaşları 37,2 ay (R, 1-192), ortalama vücut ağırlıkları 11,8 kg (R, 2,8-50) idi. Hastaların %65,7’sinde altta yatan bir hastalık vardı. En sık altta yatan hastalık %35,8 ile nörolojik hastalık grubu oluşturuyordu. Hastalarımızın %94’ü akut solunum yetmezliği, %3’ü akut kalp yetmezliği ve %3’ü şok nedeniyle YANKO tedavisi aldı. Hastalarımızın %40,3’ü pnömoni, %16,4’ü bronkopnömoni, %14,9’u bronşiolit, %11,9’u ekstübasyon sonrası akut solunum yetmezliği nedeniyle YANKO tedavisi aldı. YANKO tedavisi alan hastaların %71,6’sı entübe olmadan klinik bulguları düzeldi. YANKO sonrası hastaların solunum sayısı, kalp hızı, retraksiyon düzeylerinde istatistiksel olarak anlamlı düşüş saptandı. Altta yatan hastalığı olan ve özellikle kardiyak hastalığı olanlarda YANKO tedavisi başarısızlık oranları istatistiksel olarak anlamlı yüksek bulundu. Sonuç: Sonuç olarak, son yıllarda YANKO tedavisinin çocuklarda etkin bir şekilde kullanıldığı, vital bulgular ve kan gazı parametrelerinde düzelme sağladığı bilinmektedir. Çalışmamızda hastalarımızın %71,6’sı YANKO tedavisinden fayda gördü.

Kaynakça

1. Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) 2008. Rockville, MD: Agency for Healthcare Research and Quality. 2008.

2. Yaman A, Kendirli T, Ödek Ç, Ateş C, Taşyapar N, Güneş M, et al. Efficacy of noninvasive mechanical ventilation in prevention of intubation and reintubation in the pediatric intensive care unit. J Crit Care 2016;32(1):175-181.

3. Temel Köksoy Ö, Paksu MŞ, Yener N, Malhun Kaplan E. Non-Invasive Mechanical Ventilation Practice in Pediatric Intensive Care Unit: A Retrospective Study. J Pediatr Emerg Intensive Care Med 2016;3(2):62-68.

4. Hull J. The value of non-invasive ventilation. Arch Dis Child 2014;99(11):1050-1054.

5. Thill PJ, McGuire JK, Baden HP, Green TP, Checchia PA. Noninvasive positive-pressure ventilation in children with lower airway obstruction. Pediatr Crit Care Med 2004;5(4):337-342.

6. Wilkinson D, Andersen C, O’Donnell CP, De Paoli AG. High flow nasal cannula for respiratory support in preterm infants. Cochrane Database Syst Rev 2011:CD006405.

7. Kugelman A, Riskin A, Said W, Shoris I, Mor F, Bader D. A randomized pilot study comparing heated humidified high-flow nasal cannulae with NIPPV for RDS. Pediatr Pulmonol 2015;50(6):576-583.

8. Spentzas T, Minarik M, Patters AB, Vinson B, Stidham G. Children with respiratory distress treated with high-flow nasal cannula. J Intensive Care Med 2009;24(5):323-328.

9. Kwon JW. High-flow nasal cannula oxygen therapy in children: a clinical review. Clin Exp Pediatr 2020;63(1):3-7.

10. McKiernan C, Chua LC, Visintainer PF, Allen H. High flow nasal cannulae therapy in infants with bronchiolitis. J Pediatr 2010;156(4):634-638.

11. Schibler A, Pham TM, Dunster KR, Foster K, Barlow A, Gibbons J, et al. Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Med 2011;37(5):847-852.

12. Gupta P, Kuperstock JE, Hashmi S, Arnolde V, Gossett JM, Prodhan P, et al. Efficacy and predictors of success of noninvasive ventilation for prevention of extubation failure in critically ill children with heart disease. Pediatr Cardiol 2013;34(4):964-977.

13. Najaf-Zadeh A, Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Ann Intensive Care 2011;1(1):15.

14. Spentzas T, Minarik M, Patters AB, Vinson B, Stidham G. Children with respiratory distress treated with high-flow nasal cannula. J Intensive Care Med 2009;24(5):323-328.

15. McGinley B, Halbower A, Schwartz AR, Smith PL, Patil SP, Schneider H, et al. Effect of a high-flow open nasal cannula system on obstructive sleep apnea in children. Pediatrics 2009;124(1):179-188.

16. Pham TM, O’Malley L, Mayfield S, Martin S, Schibler A. The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis. Pediatr Pulmonol 2014;50(7):713-720.

17. Söğütlü Y, Biçer S, Kurt G, Şah O, Namdar M, Tokaç S, et al. Outcomes of high-flow nasal cannula oxygen therapy on the vital signs of children with lower respiratory tract diseases. J Pediatr Emerg Intensive Care Med 2016;3(3):121-130.

Kaynak Göster

133 126

Arşiv
Sayıdaki Diğer Makaleler

Is There Any Correlation Between De Ritis Ratio and Prostate Cancer in Males Who Underwent Transrectal Prostate Biopsy?

Yusuf ŞAHİN, Mehmet YILMAZ, İbrahim HACIBEY, Yiğit Can FİLTEKİN, Aykut ÇOLAKEROL, Atilla SEMERCİÖZ, Ahmet Yaser MÜSLÜMANOĞLU

Contribution of Endorectal Ultrasound, Magnetic Resonance Imaging and Positron Emission Tomography to Operation Strategy in Rectal Cancer

Yurdakul Deniz FIRAT, Gökhan ÇİPE, Coşkun ÇAKIR, Hüseyin Kazım BEKTAŞOĞLU, Sinan ARICI, Mahmut MÜSLÜMANOĞLU

Outcomes of Percutaneous Balloon Mitral Valvuloplasty in Significant Mitral Stenosis with Moderate Mitral Regurgitation - Single Center Study

Ömer Faruk ÇELİK, Ahmet Anıl ŞAHİN, Muammer KARAKAYALI

The Comparison of Two Versus More Than Two Tracts Percutaneous Nephrolithotomy for the Management of Staghorn Calculi

Yusuf Turushan ÖZCANLI, Mustafa ERKOÇ

The Relationship Between Interatrial Block and PASI Score in Patients with Psoriasis

Nijad BAKHSHALİYEV, Asım ENHOŞ, Erdem KARAÇÖP, Ramazan ÖZDEMİR

A Case of Severe Spontaneous Pneumomediastinum in Acquired Immunosuppressed Child with Respiratory Syncytial Virus and Human Bocavirus Co-infection

Ülkem KOÇOĞLU BARLAS, Nurhan KASAP, Nihal AKÇAY, Mey Talip PETMEZCİ, Ömer DEVECİOĞLU, Esra ŞEVKETOĞLU

High Flow Nasal Oxygen Therapy in Pediatric Intensive Care Unit

Ayhan YAMAN

Should I Perform an Electroencephalography in Patients with Syncope?

Mehlika PANPALLI ATEŞ, Fatma YILMAZ CAN

Ethics Committees in Pandemic Period: Dawn of a New Era

Adil POLAT

Is Peer Assessment Reliable in Objectively Structured Clinical Examination?

Hasan DAĞMURA, Emin DALDAL, Huseyin BAKİR, Mehmet Fatih DASİRAN, Zeki ÖZSOY, Osman DEMİR, İsmail OKAN, Ertan BÜLBÜLOĞLU