Effect of high flow nasal cannula treatment in children with respiratory distress at the general ward

Abstract

Purpose: This study evaluated the clinical effects of heated humidified high flow nasal cannula (HHHFNC) treatment in pediatric pa tients with respiratory disease and respiratory insufficiency. Methods: We reviewed the medical records for clinical features and tests performed in patients admitted to Chungnam University Hospital pediatric ward and treated with HHHFNC between July 2014 and December 2018. We evaluated the effects of HHHFNC treatment in patients with bronchiolitis treated with oxygen using a nasal prong. Results: The 136 children were treated with HHHFNC during the study period, and their median age was 8 months. Among the 136 patients, 39 (28.7%) were diagnosed with bronchiolitis and pneumonia, 42 (30.9%) with pneumonia, 28 (20.6%) with bronchiolitis, and 3 (2.2%) with epilepsy. Thirty-five patients (25.7%) had underlying neurological disorders. Fifty-one (37.5%) received invasive ventilator treatment. After HHHFNC treatment, venous blood gas analysis showed a pH increase from 7.32 to 7.37 (P<0.05) and a decrease in partial pressure of carbon dioxide (pCO2) from 53.1 to 46.2 mmHg (P<0.05). The respiratory rate had decreased from 46.3 to 43.3/min (P<0.05). There were no statistically significant differences in hospital stay duration or intensive care unit admission rates between bronchiolitis patients receiving HHHFNC treatment and those not receiving. Conclusion: In this study, in various diseases leading to pediatric respiratory insufficiency, HHHFNC treatment may improve physio logic parameters at the pediatric ward. HHHFNC may also be effective in patients with underlying neurological disorders and those with respiratory insufficiency from nonrespiratory infectious disease. (Allergy Asthma Respir Dis 2020;8:73-79)