To study the efficiency of high-flow nasal cannula in improving the arterial blood gas parameters in children admitted to pediatric intensive care unit with respiratory distress

Abstract

Abstract Background: In recent times, heated humidified high-flow nasal cannula has become increasingly popular and is now recognized as a standard respiratory support method for pediatric patients experiencing acute respiratory distress. Aims and Objectives: To study the correlation of high-flow nasal cannula (HFNC) with arterial blood gas (ABG) and clinical parameters. Materials and Methods: This prospective observational study included children aged 1 month to 14 years experiencing acute respiratory distress receiving HFNC support. Demographic information, vital signs, and ABG parameters were collected at four-time points: the first ABG at “0” h, indicating admission; the second ABG at “1” h, approximately 1 h after HFNC initiation; the third ABG at “12” h, as a follow-up after the initiation of respiratory support; and the fourth ABG at “24” h, representing daily monitoring for assessing the child’s condition and outcomes. The collected data was subjected to analysis. Results: The study included 133 children, of which 64.66% were male and 35.34% were female, with a mean age of 0.9 years (ranging from 0.3 to 3 years) and a mean weight of 7.8 kg (ranging from 4.7 to 11.8 kg). Over time, there was a statistically significant decrease in heart rate, respiratory rate, and the need for FiO2. Significant reductions in these parameters were observed within the first hour of initiating HFNC therapy, and improvements continued at 12 and 24 h compared to the baseline values (P value < 0.05). The study also revealed a decreasing trend in pCO2 and lactate levels over time. Statistically significant reductions in these parameters were noted at the first hour of HFNC initiation, and improvements persisted at 12 and 24 h compared to the baseline (P value < 0.05). On the other hand, there was an increasing trend in SpO2, pO2, base excess, and HCO3 over time. Significant increases in these parameters were observed at the first hour of HFNC initiation, and the positive trend continued at 12 and 24 h compared to the baseline (P value < 0.05). Conclusion: HFNC can serve as the primary noninvasive respiratory support for children facing respiratory distress. The majority of patients in our study demonstrated good tolerance to the HFNC. Notably, the utilization of HFNC resulted in a significant enhancement of the comfort scale among the participants. Positive changes were observed in vital parameters, comfort scale, and ABG parameters within just 1 h of initiating HFNC.