Clin Exp Pediatr.  2022 Mar;65(3):136-141. 10.3345/cep.2020.01403.

Modified high-flow nasal cannula for children with respiratory distress

• Itdhiamornkulchai S
• Preutthipan A
• Vaewpanich J
• Anantasit N

• KMID: 2527127
• DOI: http://doi.org/10.3345/cep.2020.01403

Abstract

Background
High-flow nasal cannula (HFNC) is a noninvasive respiratory support that provides the optimum flow of an air-oxygen mixture. Several studies demonstrated its usefulness and good safety profile for treating pediatric respiratory distress patients. However, the cost of the commercial HFNC is high; therefore, the modified high-flow nasal cannula was developed. Purpose: This study aimed to compare the effectiveness, safety, and nurses’ satisfaction of the modified system versus the standard commercial HFNC.
Methods
This prospective comparative study was performed in a tertiary care hospital. We recruited children aged 1 month to 5 years who developed acute respiratory distress and were admitted to the pediatric intensive care unit. Patients were assigned to 2 groups (modified vs. commercial). The effectiveness and safety assessments included vital signs, respiratory scores, intubation rate, adverse events, and nurses’ satisfaction.
Results
A total of 74 patients were treated with HFNC. Thirty- nine patients were assigned to the modified group, while the remaining 35 patients were in the commercial group. Intubation rate and adverse events did not differ significantly between the 2 groups. However, the commercial group had higher nurses’ satisfaction scores than the modified group.
Conclusion
Our findings suggest that our low-cost modified HFNC could be a useful respiratory support option for younger children with acute respiratory distress, especially in hospital settings with financial constraints.

Keyword

High-flow nasal cannula; Noninvasive respiratory support; Respiratory distress; Respiratory failure