[High flow nasal cannula in infants: Experience in a critical patient unit].

Autor:	Wegner A A; Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile. Electronic address: awegnera@gmail.com., Cespedes F P; Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Godoy M ML; Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Erices B P; Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Urrutia C L; Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Venthur U C; Pediatra, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Labbé C M; Pediatra, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Riquelme M H; Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Sanchez J C; Enfermera, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Vera V W; Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Wood V D; Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Contreras C JC; Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile., Urrutia S E; Terapista Respiratorio, UPCP Complejo Asistencial Dr. Sotero del Río, Santiago, Chile.
Jazyk:	Spanish; Castilian
Zdroj:	Revista chilena de pediatria [Rev Chil Pediatr] 2015 May-Jun; Vol. 86 (3), pp. 173-81. Date of Electronic Publication: 2015 Jul 06.
DOI:	10.1016/j.rchipe.2015.06.003
Abstrakt:	Introduction: The high flow nasal cannula (HFNC) is a method of respiratory support that is increasingly being used in paediatrics due to its results and safety. Objective: To determine the efficacy of HFNC, as well as to evaluate the factors related to its failure and complications associated with its use in infants. Patients and Method: An analysis was performed on the demographic, clinical, blood gas, and radiological data, as well as the complications of patients connected to a HFNC in a critical care unit between June 2012 and September 2014. A comparison was made between the patients who failed and those who responded to HFNC. A failure was considered as the need for further respiratory support during the first 48hours of connection. The Kolmogorov Smirnov, Mann-Whitney U, chi squared and the Exact Fisher test were used, as well as correlations and a binary logistic regression model for P≤.05. Results: The study included 109 patients, with a median age and weight: 1 month (0.2-20 months) and 3.7kg (2-10kg); 95 percentile: 3.7 months and 5.7kg, respectively. The most frequent diagnosis and radiological pattern was bronchiolitis (53.2%) and interstitial infiltration (56%). Around 70.6% responded. There was a significant difference between failure and response in the diagnosis (P=.013), radiography (P=018), connection context (P<.0001), pCO2 (median 40.7mmHg [15.4-67 mmHg] versus 47.3mmHg [28.6-71.3mmHg], P=.004) and hours on HFNC (median 60.75hrs [5-621.5 hrs] versus 10.5hrs [1-29 hrs], P<.0001). The OR of the PCO2 ≥ 55mmHg for failure was 2.97 (95% CI; 1.08-8.17; P=.035). No patient died and no complications were recorded. Conclusion: The percentage success observed was similar to that published. In this sample, the failure of HFNC was only associated with an initial pCO2 ≥ 55mmHg. On there being no complications reported as regards it use, it is considered safe, although a randomised, controlled, multicentre study is required to compare and contrast these results. (Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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