Risk factors for treatment failure of heated humidified high-flow nasal cannula as an initial respiratory support in newborn infants with respiratory distress
Autor: | Eun Hee Lee, Eui Kyung Choi, Byung Min Choi, Won Young Lee, Young Sook Hong, Jeonghee Shin |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
Hot Temperature medicine.medical_treatment Gestational Age medicine.disease_cause Antenatal steroid Hypercarbia 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Cannula Humans Intubation Treatment Failure 030212 general & internal medicine Acidosis Respiratory Distress Syndrome Newborn Noninvasive Ventilation Continuous Positive Airway Pressure Respiratory distress business.industry Infant Newborn lcsh:RJ1-570 Apnea lcsh:Pediatrics medicine.disease Respiratory acidosis Anesthesia Pediatrics Perinatology and Child Health Female medicine.symptom business Nasal cannula |
Zdroj: | Pediatrics and Neonatology, Vol 61, Iss 2, Pp 174-179 (2020) |
ISSN: | 1875-9572 |
Popis: | Background: Humidified high-flow nasal cannula (HHFNC) has gained popularity because it is easier to use, more comfortable for babies, and advantageous for mother-infant bonding. HHFNC is not inferior to other non-invasive ventilators for preventing adverse outcomes, but more studies are needed to ensure the safe use of HHFNC as an initial respiratory support for newborns. The aim of this study was to investigate risk factors for treatment failure of HHFNC as an initial respiratory support in newborns with respiratory distress after birth. Methods: We included 97 newborns who required non-invasive respiratory support within 24 h after birth. The success group included 68 infants who were successfully managed only on HHFNC, and 29 infants were the failure group who required other respiratory support because of respiratory acidosis, hypoxia, or apnea. Results: Compared with the success group, the failure group had lower GA, a higher rate of antenatal steroid use, prolonged rupture of membrane, lower pH, higher pCO2 on blood-gas analysis after HHFNC application and higher incidence of respiratory distress syndrome of newborn (RDS). After adjusting for GA, higher FiO2 settings during acidosis, hypercarbia after the application of HHFNC shown on blood-gas analysis and the presence of RDS remained significant. The rate of treatment failure was 16.2% for ≥36 weeks, 19.3% for ≥34 weeks, and 22.1% for ≥33 weeks. Conclusion: Treatment failure of HHFNC should be considered a risk for newborns of less than 34 weeks and infants with respiratory distress from RDS. Higher FiO2 settings during HHFNC, and acidosis and hypercarbia after the application of HHFNC shown on blood-gas analysis may help identify high-risk newborns for other non-invasive ventilators or intubation. Key Words: high-flow nasal cannula, newborn infant, noninvasive ventilation, respiratory distress |
Databáze: | OpenAIRE |
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