High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study

Pilar, J.; Alapont, V. Modesto i; López-Fernández, Yolanda M; Lopez-Macias, O.; García-Urabayen, D.; Amores-Hernández, Irene

doi:10.1016/j.medine.2017.01.007

Cited by 7 publications

(7 citation statements)

References 29 publications

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“…A delay in escalation to NIV may be associated with worse outcomes in children with asthma. 18 Aerosol delivery via HFNC is somewhat controversial. 19,20 Bench studies to date indicate that aerosol is delivered to the airway; however in vivo data from humans are lacking.…”

Section: Discussionmentioning

confidence: 99%

High-Flow Nasal Cannula in Pediatric Patients: A Survey of Clinical Practice

et al. 2018

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Section: Discussionmentioning

confidence: 99%

High-Flow Nasal Cannula in Pediatric Patients: A Survey of Clinical Practice

et al. 2018

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“…52 An observational study by Pilar et al investigated the outcomes of children with asthma who were treated with HFNC or NIV. 61 The study showed no failure in the NIV group, while respiratory support had to be changed to NIV among 40% of children in the HFNC group, thus showing that CPAP was associated with a more rapid improvement in respiratory distress. 61 Collectively speaking, while CPAP and HFNC were both associated with improvement in respiratory distress, CPAP was superior in treating children with significant respiratory distress.…”

Section: Comparison Of Therapiesmentioning

confidence: 83%

“…61 The study showed no failure in the NIV group, while respiratory support had to be changed to NIV among 40% of children in the HFNC group, thus showing that CPAP was associated with a more rapid improvement in respiratory distress. 61 Collectively speaking, while CPAP and HFNC were both associated with improvement in respiratory distress, CPAP was superior in treating children with significant respiratory distress. On the other hand, HFNC was associated with improved tolerance in comparison to NIV.…”

Section: Comparison Of Therapiesmentioning

confidence: 83%

Noninvasive Ventilation and High-Flow Nasal Cannulae Therapy for Children with Acute Respiratory Failure: An overview

Al-Mukhaini

Al-Rahbi

2018

Sultan Qaboos Univ Med J

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Noninvasive ventilation (NIV) refers to the use of techniques to deliver artificial respiration to the lungs without the need for endotracheal intubation. As NIV has proven beneficial in comparison to invasive mechanical ventilation, it has become the optimal modality for initial respiratory support among children in respiratory distress. High-flow nasal cannulae (HFNC) therapy is a relatively new NIV modality and is used for similar indications. This review discusses the usefulness and applications of conventional NIV in comparison to HFNC.Keywords: Noninvasive Ventilation; Nasal Cannulae; Endotracheal Intubation; Mechanical Ventilation; Children.

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“…The effects of HFNC on aerosol delivery and escalation of therapy remains controversial. [16][17][18][19][20][21][22] The role of NIV in pediatric asthma is also unclear due to lack of data from high-quality randomized, controlled trials.…”

Section: Discussionmentioning

confidence: 99%

A Respiratory Therapist-Driven Asthma Pathway Reduced Hospital Length of Stay in the Pediatric Intensive Care Unit

et al. 2019

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BACKGROUND: Asthma is a common reason for admissions to the pediatric intensive care unit (PICU). Since June 2014, our institution has used a pediatric asthma clinical pathway for all patients, including those in PICU. The pathway promotes respiratory therapist-driven bronchodilator weaning based on the Modified Pulmonary Index Score (MPIS). This pathway was associated with decreased hospital length of stay (LOS) for all pediatric asthma patients; however, the effect on PICU patients was unclear. We hypothesized that the implementation of a pediatric asthma pathway would reduce hospital LOS for asthmatic patients admitted to the PICU. METHODS: We retrospectively reviewed the medical records of all pediatric asthma subjects 2-17 y old admitted to our PICU before and after pathway initiation. Primary outcome was hospital LOS. Secondary outcomes were PICU LOS and time on continuous albuterol. Data were analyzed using the chi-square test for categorical data, the t test for normally distributed data, and the Mann-Whitney test for nonparametric data. RESULTS: A total of 203 eligible subjects (49 in the pre-pathway group, 154 in the post group) were enrolled. There were no differences between groups for age, weight, gender, home medications, cause of exacerbation, medical history, or route of admission. There were significant decreases in median (interquartile range) hospital LOS (4.4 [2.9 -6.6] d vs 2. 7 [1.6 -4.0] d, P < .001), median PICU LOS (2.1 [1.3-4.0] d vs 1.6 [0.8 -2.4] d, P ‫؍‬ .003), and median time on continuous albuterol (39 [25-85] h vs 27 [13-42] h, P ‫؍‬ .001). Significantly more subjects in the post-pathway group were placed on high-flow nasal cannula (32% vs 6%, P ‫؍‬ .001) or noninvasive ventilation (10% vs 4%, P ‫؍‬ .02). CONCLUSION: The implementation of an asthma pathway was associated with decreased hospital LOS, PICU LOS, and time on continuous albuterol. There was also an increase in the use of high-flow nasal cannula and noninvasive ventilation after the implementation of this clinical pathway.

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High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study

Cited by 7 publications

References 29 publications

High-Flow Nasal Cannula in Pediatric Patients: A Survey of Clinical Practice

High-Flow Nasal Cannula in Pediatric Patients: A Survey of Clinical Practice

Noninvasive Ventilation and High-Flow Nasal Cannulae Therapy for Children with Acute Respiratory Failure: An overview

A Respiratory Therapist-Driven Asthma Pathway Reduced Hospital Length of Stay in the Pediatric Intensive Care Unit

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