Allergy Asthma Respir Dis.  2023 Jan;11(1):26-33. 10.4168/aard.2023.11.1.26.

High-flow nasal cannula therapy for children with complex chronic disease in the general ward: A single, tertiary center experience

• Lee BR
• Kim MJ
• Kim JH
• Choi YJ
• Park JS
• Suh DI

• KMID: 2538969
• DOI: http://doi.org/10.4168/aard.2023.11.1.26

Abstract

Purpose
We aimed to evaluate the usefulness and safety of high-flow nasal cannula (HFNC) oxygen therapy in children with complex chronic diseases (CCD) with impending respiratory failure in the general ward.
Methods
Medical records of subjects with HFNC oxygen use in the general ward at a Korean tertiary children’s hospital were reviewed. Children with CCD and impending respiratory failure were included. treatment success was defined as successful weaning from HFNC oxygen support and treatment failure as weaning failure that led to higher level of respiratory support such as invasive ventilation or noninvasive positive pressure ventilation.
Results
Fifty cases were included. Thirty-five cases (70%) were weaned off HFNC oxygen successfully, 15 cases (30%) failed. At the time of HFNC oxygen administration, the treatment failure group showed higher heart rate (P = 0.043), carbon dioxide partial pressure (P = 0.002), and initial inspired oxygen fraction (P = 0.007). Within 72 hours of initial treatment, 20% of patients in the treatmentsuccess group were weaned off the HFNC oxygen and half in the treatment-failure group required invasive ventilation. One case experienced complication.
Conclusion
HFNC oxygen is safe and effective for respiratory support in the general ward to avoid invasive mechanical ventilation in children with CCD and impending respiratory failure.

Keyword

Respiratory insufficiency; Respiratory therapy; Oxygen inhalation therapy; Chronic disease; General ward