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. 2023 Apr 1;6(4):e1182.
doi: 10.1002/hsr2.1182. eCollection 2023 Apr.

Use of high-flow cannula in pediatric patients with respiratory failure: A prospective cohort study in three high-altitude hospitals

Natalia Ante-Ardila  1 , Camilo Novoa Garnica  1 , Paola Mora Umaña  1 , Olga Lucía Baquero Castañeda  2   3 , Alexandra Jiménez Cháves  3 , Melisa Sofía Naranjo  2 , Juan G Piñeros  1   2   4 , Carolina Bonilla  2   4 , Luz M Mejía  2   5 , María L Mesa-Rubio  1   2 , Sonia Restrepo-Gualteros  2   4 , Pedro Barrera  2 , Sergio Moreno-Lopez  2 , Paola Rueda-Guevara  2 , Andrea Ramírez Varela  2 ; FARA Group
Affiliations

Use of high-flow cannula in pediatric patients with respiratory failure: A prospective cohort study in three high-altitude hospitals

Natalia Ante-Ardila et al. Health Sci Rep. .

Abstract

Background and aims: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals.

Methods: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management.

Results: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%.

Conclusion: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies.

Keywords: critical care medicine; emergency medicine; pediatrics and adolescent medicine; respiratory medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient eligibility flow‐diagram. ER, emergency room; HFNC, high‐flow nasal cannula; PICU, pediatric intensive care unit.
See this image and copyright information in PMC

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