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- Title
High-flow nasal cannula failure: can clinical outcomes determine early interruption?
- Authors
Siciliano Nascimento, Milena; Ribeiro Quinto, Danielle Eugênia; Cristina Zamberlan, Gisele; Zamprônio dos Santos, Adriana; Moura Rebello, Celso; do Prado, Cristiane
- Abstract
Objective: To evaluate the evolution of clinical outcomes in children with bronchiolitis who used a high-flow nasal cannula, and to determine after long of non-clinical improvement the therapy should be discontinued, and treatment should be escalated to other forms of ventilatory support. Methods: An observational retrospective study of infants with bronchiolitis who used a highflow nasal cannula. Patients were divided into two study groups according to success or failure of high-flow nasal cannula therapy, namely the Success Group and the Failure Group. The main demographics and clinical variables were assessed 30 minutes and 6 hours after initiating therapy until removal of the high-flow nasal cannula. Results: A total of 83 children were studied and 18 children (21.7%) failed therapy. Among subjects with successful therapy, a significant decrease in respiratory rate (p<0.001), and a significant increase in peripheral oxygen saturation (p<0.001) were observed within 30 minutes. The Success Group was significantly different from the Failure Group after 6 hours, for both respiratory rate (p<0.01) and peripheral oxygen saturation (p<0.01). Conclusion: The absence of clinical sign improvement within 30 minutes and for up to a maximum of 6 hours can be considered as failure of the high-flow nasal cannula therapy. If this time elapses with no improvements, escalating to another type of ventilatory support should be considered.
- Subjects
NASAL cannula; BRONCHIOLITIS; TREATMENT effectiveness; OXYGEN saturation; ARTIFICIAL respiration
- Publication
Einstein (16794508), 2021, Vol 19, p1
- ISSN
1679-4508
- Publication type
Article
- DOI
10.31744/einstein_journal/2021AO5846