Effect of flow rate on the end‐expiratory lung volume in infants with bronchiolitis using high‐flow nasal cannula evaluated through electrical impedance tomography

Autor: Milena S. Nascimento, Cristiane do Prado, Eduardo L. V. Costa, Glasiele C. Alcala, Letícia C. Corrêa, Felipe S. Rossi, Marcelo B. P. Amato, Celso M. Rebello
Rok vydání: 2022
Předmět:
Zdroj: Pediatric Pulmonology. 57:2681-2687
ISSN: 1099-0496
8755-6863
Popis: To evaluate the effects of four flow rates on the functional residual capacity (FRC) and pulmonary ventilation distribution while using a high-flow nasal cannula (HFNC).Our hypothesis is that flow rates below 1.5 L·kgsup-1/sup·minsup-1/suplead to FRC loss and respiratory distress.A single-center, prospective clinical study.Infants diagnosed with acute viral bronchiolitis were given HFNC.Through a prospective clinical study, the effects of four different flow rates, 2.0, 1.5, 1.0, and 0.5 L·kgsup-1/sup·minsup-1/sup, on FRC and the pulmonary ventilation pattern were evaluated using electrical impedance tomography. The impedance variation (delta Z), end-expiratory lung volume (EELZ), respiratory rate, heart rate, respiratory distress score, and saturation/fraction of inspired oxygen ratio (SpOsub2/sub/FsubI/subOsub2/sub), were also evaluated at each flow rate.Among the 11 infants included, There was a decrease in respiratory distress score at a flow rate of 1.5 L·kgsup-1/sup·minsup-1/sup(*p = 0.021), and at a flow rate of 2.0 L·kgsup-1/sup·minsup-1/sup(**p = 0.003) compared to 0.5 L·kgsup-1/sup·minsup-1/sup. There was also a small but significant increase in SpOsub2/sub/FiOsub2/subat flow rates of 1.5 (*p = 0.023), and 2.0 L·kgsup-1/sup·minsup-1/sup(**p = 0.008) compared to 0.5 L·kgsup-1/sup·minsup-1/sup. There were no other significant changes in the clinical parameters. In the global EELZ measurements, there was a significant increase under a flow rate of 2.0 L·kgsup-1/sup·minsup-1/supas compared to 0.5 L·kgsup-1/sup·minsup-1/sup(p = 0.03). In delta Z values, there were no significant variations between the different flow rates.The ∆EELZ increases at the highest flow rates were accompanied by decreased distress scores and improved oxygenation.
Databáze: OpenAIRE
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