High-flow nasal cannula therapy for children with complex chronic disease in the general ward: A single, tertiary center experience
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Purpose: We aimed to evaluate the usefulness and safety of high-flow nasal cannula (HFNC) oxygen therapy in children with complex chronic diseases (CCD) with impending respiratory failure in the general ward. Methods: Medical records of subjects with HFNC oxygen use in the general ward at a Korean tertiary children’s hospital were reviewed. Children with CCD and impending respiratory failure were included. treatment success was defined as successful weaning from HFNC oxygen support and treatment failure as weaning failure that led to higher level of respiratory support such as invasive ventilation or noninvasive positive pressure ventilation. Results: Fifty cases were included. Thirty-five cases (70%) were weaned off HFNC oxygen successfully, 15 cases (30%) failed. At the time of HFNC oxygen administration, the treatment failure group showed higher heart rate (P=0.043), carbon dioxide partial pressure (P=0.002), and initial inspired oxygen fraction (P=0.007). Within 72 hours of initial treatment, 20% of patients in the treatment-success group were weaned off the HFNC oxygen and half in the treatment-failure group required invasive ventilation. One case experienced complication. Conclusion: HFNC oxygen is safe and effective for respiratory support in the general ward to avoid invasive mechanical ventilation in children with CCD and impending respiratory failure.
Abstract
Purpose: We aimed to evaluate the usefulness and safety of high-flow nasal cannula (HFNC) oxygen therapy in children with complex chronic diseases (CCD) with impending respiratory failure in the general ward. Methods: Medical records of subjects with HFNC oxygen use in the general ward at a Korean tertiary children’s hospital were reviewed. Children with CCD and impending respiratory failure were included. treatment success was defined as successful weaning from HFNC oxygen support and treatment failure as weaning failure that led to higher level of respiratory support such as invasive ventilation or noninvasive positive pressure ventilation. Results: Fifty cases were included. Thirty-five cases (70%) were weaned off HFNC oxygen successfully, 15 cases (30%) failed. At the time of HFNC oxygen administration, the treatment failure group showed higher heart rate (P=0.043), carbon dioxide partial pressure (P=0.002), and initial inspired oxygen fraction (P=0.007). Within 72 hours of initial treatment, 20% of patients in the treatment-success group were weaned off the HFNC oxygen and half in the treatment-failure group required invasive ventilation. One case experienced complication. Conclusion: HFNC oxygen is safe and effective for respiratory support in the general ward to avoid invasive mechanical ventilation in children with CCD and impending respiratory failure.
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