Clinical Factors of High-Flow Nasal Cannula Oxygen Success in Children

Abstract

This study was aimed to evaluate the success rate of high-flow nasal cannula (HFNC) oxygen therapy and factors causing therapy failure. This prospective observational study included 131 children who received HFNC oxygen and followed-up in the pediatric emergency department, pediatric clinics, and pediatric intensive care unit between March 2018 and December 2019. The median age was 23.0 months (interquartile range [IQR]: 9.0–92.0) and 65 patients were male (49.6%). The most common reason for requiring HFNC oxygen therapy was pneumonia (n = 75, 57.3%). A complex chronic condition was present in 112 (85.5%) patients. Therapy success was achieved in 116 patients (88.5%). The reason for requiring treatment and the patients' complex chronic condition did not affect the success of the therapy (p = 0.294 and 0.091, respectively). In the first 24 hours of treatment, a significant improvement in pulse rate, respiratory rate, pH, and lactate level were observed in successful HFNC oxygen patients (p < 0.05). In addition, these patients showed a significant improvement in SpO2 and SpO2/FiO2 ratio, and a significant decrease in FiO2 and flow rate (p < 0.05). HFNC oxygen success rate was 95.6% in patients with SpO2/FiO2 ≥ 150 at the 24th hour; it was 58.0% in those with SpO2/FiO2 < 150 (p < 0.001). Caution should be exercised in terms of HFNC oxygen failure in patients with no significant improvement in vital signs and with SpO2/FiO2 < 150 during treatment.

ROX index as a predictor of failure of high-flow nasal cannula in infants with bronchiolitis

“…The literature has evaluated clinical signs such as SpO 2 , FiO 2 , the S/F ratio, the respiratory rate, and respiratory distress alone, but a consensus has not been reached. While some authors 8 , 26 highlighted respiratory rate, FiO 2 and SpO 2 in the successful group in the treatment of HFNC in the first hours, others 9 , 27 showed variables such as HR and initial respiratory acidosis as significant predictors of HFNC failure.…”

Outcome of high-flow nasal cannula (HFNC) therapy in respiratory failure due to lower respiratory tract infections in PICU - a single center experience in Karachi, Pakistan.

“…Iplik et al from Turkey recently reported the relatively higher success rate of HFNC as 88.5% among children who were unable to maintain SpO 2 > 92% in the pediatric emergency on oxygen supplementation administration. 10 Iplik et al included cases adhering various etiologies while we only included cases who were reported with lower respiratory tract infections. Local study by Saeed et al reported the success of HFNC among children with acute respiratory insufficiency in PICU as 76.7%.…”

“…METHODS This analytical, observational, cross-sectional study was conducted at the PICU of The Indus Hospital, Karachi, Pakistan from November 2022 to October 2023 after the approval of "Institutional Review Board" (letter number: IHHN_IRB_2022_12_037). A sample size of 62 was calculated considering the the success of HFNC as 88.5% in PICU 10 , with 8% margin of error and 95% confidence level.…”

Uso de cánula nasal de alto flujo CNAF en emergencia pediatría del Hospital de Lima Este-Vitarte, 2024-Perú

“…% (9) fueron derivados a la unidad de cuidados intensivos pediátricos, el 14 % (5) fracasó la terapia por signos de inestabilidad y agotamiento llegando a ser entubados estos pacientes, estos datos coinciden con los estudios de,Udurgucu et al (Udurgucu, M.et al, 2022) evidenciaron que el destete exitoso de la CNAF se obtuvo en el 76,9 % de los pacientes, en el 82,1 % del destete de flujo y en el 73,6 % del destete directo Iplik et al (Iplik, G., Yıldızdaş, D., & Yontem, A. 2021…”