Safety of High-Flow Nasal Cannula Outside the ICU for Previously Healthy Children With Bronchiolitis
| Autor: | Gabriella Azzarone, Nina M. Dadlez, Yi Shi, Asama Khan, Nora Esteban-Cruciani, William N. Southern, Kevin J McKenna |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine medicine.disease_cause Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Cannula Humans Medicine Intubation Adverse effect Noninvasive Ventilation Clinical Deterioration Respiratory distress business.industry Infant General Medicine medicine.disease Pneumonia Outcome and Process Assessment Health Care 030228 respiratory system Pneumothorax Bronchiolitis Concomitant Female Patient Safety business Nasal cannula |
| Zdroj: | Respiratory Care. 64:1410-1415 |
| ISSN: | 1943-3654 0020-1324 |
| DOI: | 10.4187/respcare.06352 |
| Popis: | BACKGROUND: High-flow nasal cannula (HFNC), a form of noninvasive respiratory support, is effective for the treatment of respiratory distress in ICUs. Although HFNC has been used outside of the ICU, there is little research that examines its safety in this less-monitored setting. METHODS: Children ≤ 24 months old admitted with bronchiolitis to a pediatric floor at a tertiary care center from April 1 2013, to March 31 2015, were identified by using standard diagnostic codes. Exclusion criteria were concomitant pneumonia or complex comorbidities. Demographic and clinical characteristics were abstracted. Outcomes included transfer to the ICU, higher levels of respiratory support, intubation, pneumothorax, or aspiration events. RESULTS: Eighty children admitted with bronchiolitis who were treated with HFNC while on the pediatric floor were examined. The median age was 4.6 months, 45% were girls, and the majority were either Hispanic (41%) or black (36%). Flow ranged from 3 to 10 L/min. Thirty-three subjects (41% of the sample) required subsequent transfer to the ICU. No children were intubated or developed a pneumothorax. Eighty-three percent were fed while on HFNC. No children had an aspiration event. CONCLUSIONS: HFNC may be a safe modality of respiratory support outside of the ICU for children ages ≤ 24 months with bronchiolitis and without comorbidities up to a maximum flow of 10 L/min. There were no adverse events among the subjects who were fed while on HFNC. |
| Databáze: | OpenAIRE |
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