Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia
Ali Alsuheel Asseri,1 Youssef Ali AlQahtani,1 Ahmad Ali Alhanshani,1 Ghada Haider Ali,2 Ibrahim Alhelali2 1Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia; 2Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi ArabiaCorrespondence: A...
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doaj-ff3320d220f34821bc8065cd505fa7bb2021-08-31T20:24:17ZengDove Medical PressPediatric Health, Medicine and Therapeutics1179-99272021-08-01Volume 1243143768371Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi ArabiaAsseri AAAlQahtani YAAlhanshani AAAli GHAlhelali IAli Alsuheel Asseri,1 Youssef Ali AlQahtani,1 Ahmad Ali Alhanshani,1 Ghada Haider Ali,2 Ibrahim Alhelali2 1Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia; 2Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi ArabiaCorrespondence: Ali Alsuheel AsseriDepartment of Child Health, College of Medicine, King Khalid University, Abha, Saudi ArabiaTel +966 500186013; +966 172418589Email alsoheel11@kku.edu.saBackground: High flow nasal cannula (HFNC) is a new device for respiratory support. Its use continues to increase in pediatrics as its system is easily set up and well tolerated by patients. We aimed in this study to explore indications and safety of HFNC use and predictors of HFNC failure.Methods: Hospital records of 92 children with acute respiratory distress admitted to the pediatric intensive care unit (PICU) in Abha Maternity and Children Hospital from January 2018 until March 2020 and received HFNC therapy were studied. A data collection sheet was used that included patients’ age, gender, the indication of HFNC, associated chronic diseases, previous admission to PICU, vital signs (initially, 8 hours and 48 hours after using HFNC), outcome after using HFNC, and reasons for HFNC failure.Results: After receiving HFNC, children’s respiratory rate, heart rate, systolic blood pressure, and oxygen saturation improved significantly (p < 0.001, p < 0.001, p < 0.001, p = 0.005, and p < 0.001, respectively). Regarding laboratory findings, pH and serum bicarbonate improved significantly (p < 0.001 for both), while PaCO2 improved but not significantly. The failure rate of HFNC was 23.0%. HFNC failure rates were significantly higher among children with chronic diseases than those with no chronic disease (33.3% and 14.9%, respectively, p = 0.038) and among children with the air-leak syndrome (p < 0.001). After 48 hours of HFNC use, children who experienced HFNC failure had significantly higher respiratory and heart rates (p < 0.001 and p = 0.018, respectively), lower diastolic blood pressure (p = 0.011), and higher PaCO2 (p < 0.001).Conclusion: After HFNC use, significant improvements occur in all clinical parameters and laboratory values of children with respiratory distress, but about one-fourth of cases may experience HFNC failure. Predictors for HFNC failure include underlying chronic disease, low diastolic blood pressure, high respiratory rate, high heart rate, high initial PaCO2.Keywords: high flow nasal cannula, respiratory distress, pediatric intensive care, Saudi Arabiahttps://www.dovepress.com/indications-and-safety-of-high-flow-nasal-cannula-in-pediatric-intensi-peer-reviewed-fulltext-article-PHMThigh flow nasal cannularespiratory distresspediatric intensive caresaudi arabia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Asseri AA AlQahtani YA Alhanshani AA Ali GH Alhelali I |
spellingShingle |
Asseri AA AlQahtani YA Alhanshani AA Ali GH Alhelali I Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia Pediatric Health, Medicine and Therapeutics high flow nasal cannula respiratory distress pediatric intensive care saudi arabia |
author_facet |
Asseri AA AlQahtani YA Alhanshani AA Ali GH Alhelali I |
author_sort |
Asseri AA |
title |
Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia |
title_short |
Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia |
title_full |
Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia |
title_fullStr |
Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia |
title_full_unstemmed |
Indications and Safety of High Flow Nasal Cannula in Pediatric Intensive Care Unit: Retrospective Single Center Experience in Saudi Arabia |
title_sort |
indications and safety of high flow nasal cannula in pediatric intensive care unit: retrospective single center experience in saudi arabia |
publisher |
Dove Medical Press |
series |
Pediatric Health, Medicine and Therapeutics |
issn |
1179-9927 |
publishDate |
2021-08-01 |
description |
Ali Alsuheel Asseri,1 Youssef Ali AlQahtani,1 Ahmad Ali Alhanshani,1 Ghada Haider Ali,2 Ibrahim Alhelali2 1Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia; 2Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi ArabiaCorrespondence: Ali Alsuheel AsseriDepartment of Child Health, College of Medicine, King Khalid University, Abha, Saudi ArabiaTel +966 500186013; +966 172418589Email alsoheel11@kku.edu.saBackground: High flow nasal cannula (HFNC) is a new device for respiratory support. Its use continues to increase in pediatrics as its system is easily set up and well tolerated by patients. We aimed in this study to explore indications and safety of HFNC use and predictors of HFNC failure.Methods: Hospital records of 92 children with acute respiratory distress admitted to the pediatric intensive care unit (PICU) in Abha Maternity and Children Hospital from January 2018 until March 2020 and received HFNC therapy were studied. A data collection sheet was used that included patients’ age, gender, the indication of HFNC, associated chronic diseases, previous admission to PICU, vital signs (initially, 8 hours and 48 hours after using HFNC), outcome after using HFNC, and reasons for HFNC failure.Results: After receiving HFNC, children’s respiratory rate, heart rate, systolic blood pressure, and oxygen saturation improved significantly (p < 0.001, p < 0.001, p < 0.001, p = 0.005, and p < 0.001, respectively). Regarding laboratory findings, pH and serum bicarbonate improved significantly (p < 0.001 for both), while PaCO2 improved but not significantly. The failure rate of HFNC was 23.0%. HFNC failure rates were significantly higher among children with chronic diseases than those with no chronic disease (33.3% and 14.9%, respectively, p = 0.038) and among children with the air-leak syndrome (p < 0.001). After 48 hours of HFNC use, children who experienced HFNC failure had significantly higher respiratory and heart rates (p < 0.001 and p = 0.018, respectively), lower diastolic blood pressure (p = 0.011), and higher PaCO2 (p < 0.001).Conclusion: After HFNC use, significant improvements occur in all clinical parameters and laboratory values of children with respiratory distress, but about one-fourth of cases may experience HFNC failure. Predictors for HFNC failure include underlying chronic disease, low diastolic blood pressure, high respiratory rate, high heart rate, high initial PaCO2.Keywords: high flow nasal cannula, respiratory distress, pediatric intensive care, Saudi Arabia |
topic |
high flow nasal cannula respiratory distress pediatric intensive care saudi arabia |
url |
https://www.dovepress.com/indications-and-safety-of-high-flow-nasal-cannula-in-pediatric-intensi-peer-reviewed-fulltext-article-PHMT |
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