Oxygen therapy via high flow nasal cannula in pediatric intensive care unit

Oto A, Erdoğan S, Boşnak M. Oxygen therapy via high flow nasal cannula in pediatric intensive care unit. Turk J Pediatr 2016; 58: 377-382.The aim of the present study was to assess the efficacy and safety of oxygen therapy via high flow nasal cannula in pediatric patients with acute respiratory failure. Patients who were admitted to pediatric intensive care unit and were administered high flow nasal cannula (HFNC) therapy between January 2015 and January 2016 were enrolled. Arterial blood gas parameters, respiratory rates (RR), heart rates (HR), systolic, diastolic, and mean arterial pressures (SBP, DBP, MAP), dyspnea scores, fractional oxygen indices (FiO2), and oxygen saturations (SatO2) were recorded at baseline, 30 minutes, and 12 hours.The study enrolled a total of 50 patients of whom 24 (48%) were female and 26 (52%) were male. Statistically significant reductions occurred in mean HR and RR values at 30 minutes and 12 hours compared to those at 0 minute (p<0.05). Significant increases were observed in SatO2 values at 30 minutes (p.0.001) and 12 hours (p:0.005) compared to SatO2 value at 0 minute (p<0.05). Similarly, there occurred significant reductions in mean FiO2 values at 30 minutes and 12 hours compared to baseline (p<0.05). Significant reductions occurred in mean dyspnea score at 30 minutes (p:0.001) and 12 hours (p:0.001) compared to that at 0minute (p<0.05). pH, PaCO2, PaO2, SBP, and DBP values at 0 minute, 30 minutes, and 12 hours were not significantly different from one another (p>0.05). No significant correlations were found between treatment failure and age at admission; mean pediatric index of mortality (PIM II), pediatric risk of mortality (PRISM), pediatric logistic organ dysfunction (PELOD) and pediatric multiple organ dysfunction score (P-MODS); and HR, RR, SatO, pH, PaCO2, PaO2, SBP, DBP, MAP, FiO2 at baseline (p>0.05). Therapy was successful in 40 (80%) patients whereas there occurred a need for invasive ventilation in 10 (20%) patients. High flow nasal oxygen therapy can be used for patients with acute severe hypoxemic respiratory failure without concurrent hypercapnia when adequate equipment and monitorization tools exist.

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