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Nasal cannula pediatric7/25/2023 ![]() 12 HFNC may also deliver CPAP, 8, 9, 12, 14– 16 although the exact amount of pressure may be unpredictable. 9 It is thought that HFNC supports respiration by reducing work of breathing, 9– 13 decreasing patient work expenditure to heat, improving lung compliance, 8, 13 eliminating dead space, 10 and increasing lung mucociliary clearance. 4– 6 This delivery method produces heated, humidified air and oxygen 7, 8 at flows >2 L/kg/min. Oxygen therapy via high-flow nasal cannula (HFNC) is an increasingly utilized form of noninvasive respiratory support that is safe and well tolerated by patients. ![]() Noninvasive methods of respiratory support, including simple and high-flow oxygen via nasal cannula, CPAP, and noninvasive ventilation (NIV), are alternative means of treating respiratory insufficiency to avoid the need for mechanical ventilation and prevent extubation failure. 1 Whereas endotracheal intubation and mechanical ventilation is an established, effective supportive therapy for respiratory failure, it is associated with increased risk for infection, lung and airway injury, length of stay, and sedation-related complications with related high costs. Respiratory illnesses are the most common conditions leading to pediatric hospitalizations, with asthma and pneumonia among the top 10 diagnoses in all pediatric age groups. Of the 63 subjects with congenital heart disease, 92% of the utilization was postextubation. HFNC was used as postextubation support in 16% of the subjects. 01) however, this was an older population, and peak oxygen concentration did not differ between the 2 groups (49.8% vs 47.1%, P =. When compared with all other respiratory viral illness, subjects with rhinovirus/enterovirus required a higher peak flow (14.9 L vs 13.1 L, P =. Respiratory viral infections were detected by polymerase chain reaction in 334 subjects managed with HFNC (53.8%) and included 260 subjects testing positive for rhinovirus/enterovirus. Of the subjects admitted with a primary diagnosis of status asthmaticus, 41% required management with terbutaline. Reported primary indications for the utilization of HFNC were status asthmaticus (24%), status asthmaticus with pneumonia (17%), and bronchiolitis (16%). The average age was 3.74 y (range 0–18.1 y), and subjects were 44% female and 65% African American. View abstract here.RESULTS: Over the enrollment study period, 620 subjects with HFNC were managed, which represented 27% of total ICU admissions. Miller, A.G., Gentle, M.A., Tyler, L.M., & Napolitano, N. High-Flow Nasal Cannula in Pediatric Patients: A Survey of Clinical Practice.Schmidt, O. et al. Real-life effectiveness of asthma treatment with a fixed-dose fluticasone/formoterol pressurised metered-dose inhaler - Results from a non-interventional study.High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial. Successful Deployment of High Flow Nasal Cannula in a Peruvian Pediatric Intensive Care Unit Using Implementation Science-Lessons Learned. Nielsen K.R., Becerra R., Mallma G., Tantaleán da Fieno J.Franklin D., Shellshear D., Babl F.E. on behalf of PARIS and PREDICT, et al. Multicentre, randomised trial to investigate early nasal high-flow therapy in paediatric acute hypoxaemic respiratory failure: a protocol for a randomised controlled trial-a Paediatric Acute respiratory Intervention Study (PARIS 2) BMJ Open 9, e030516 (2019).et al. FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): protocol for a multicentre randomised feasibility trial of non-invasive respiratory support in critically ill children. High-flow nasal cannula oxygen therapy for infants with bronchiolitis: a pilot study. Mayfield, S., Bogossian, F., O’Malley, L., & Schibler, A.et al. Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. et al. A randomized trial of high-flow oxygen therapy in infants with bronchiolitis. The effect of high-flow nasal cannula therapy on the work of breathing in infants with bronchiolitis. Pham, T., O’Malley, L., Mayfield, S., Martin, S., & Schibler, A.Effort of breathing in children receiving high-flow nasal cannula. et al. Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study.
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