Abstract
Aims & Objectives: Aim High Flow Nasal Cannula (HFNC) is a form of non-invasive ventilatory (NIV) support that involves delivery of oxygen with heated high flow air. HFNC improves oxygenation and reduce minute ventilation requirements in patients with respiratory disease. Hospital Selayang and Sungai Buloh are tertiary referral hospitals without PICU. Children with acute respiratory distress will either be intubated or transferred out, prior to HFNC usage. This study is to look at the effectiveness of HFNC usage determined by the rate of intubation or requirement of other forms of NIV (mechanical ventilation). Objective To determine the need of mechanical ventilation upon initiating HFNC in general paediatric wards. Methods A retrospective cohort study of 10 months from January till October 2017. HFNC use based on the discretion of the attending paediatrician. Clinical outcomes assessed by responder or non-responder (requiring mechanical ventilation within 6 hours of initiation). Results Two hundred nineteen (219) patients included, with 194 (89%) responded to HFNC. Twenty-five non-responders; 24 were upgraded to NIV and 1 was intubated. Non-responders require higher FiO2 of 0.39 (p <0.005), lower SpO2 of 94% (p = 0.241) and higher PRESS score of 4 (p=0.09) pretreatment. There was no correlation with CXR findings.Conclusions HFNC is effective for usage in paediatric ward.
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