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- Title
Safety of High-Flow Nasal Cannula Outside the ICU for Previously Healthy Children With Bronchiolitis.
- Authors
Dadlez, Nina M.; Esteban-Cruciani, Nora; Khan, Asama; Yi Shi; McKenna, Kevin J.; Azzarone, Gabriella; Southern, William N.
- Abstract
BACKGROUND: High-flow nasal cannula (HFNC), a form of noninvasive respiratory support, is effective for the treatment of respiratory distress in ICUs. Although HFNC has been used outside of the ICU, there is little research that examines its safety in this less-monitored setting. METHODS: Children < 24 months old admitted with bronchiolitis to a pediatric floor at a tertiary care center from April 1 2013, to March 31 2015, were identified by using standard diagnostic codes. Exclusion criteria were concomitant pneumonia or complex comorbidities. Demographic and clinical characteristics were abstracted. Outcomes included transfer to the ICU, higher levels of respiratory support, intubation, pneumothorax, or aspiration events. RESULTS: Eighty children admitted with bronchiolitis who were treated withHFNCwhile on the pediatric floor were examined. The median age was 4.6 months, 45% were girls, and the majority were either Hispanic (41%) or black (36%). Flow ranged from 3 to 10 L/min. Thirty-three subjects (41% of the sample) required subsequent transfer to the ICU. No children were intubated or developed a pneumothorax. Eighty-three percent were fed while on HFNC. No children had an aspiration event. CONCLUSIONS: HFNC may be a safe modality of respiratory support outside of the ICU for children ages ≤ 24 months with bronchiolitis and without comorbidities up to a maximum flow of 10 L/min. There were no adverse events among the subjects who were fed while on HFNC.
- Subjects
NEW York (State); RESPIRATORY insufficiency treatment; ARTIFICIAL respiration; BLACK people; CHI-squared test; CHILDREN'S hospitals; ENTERAL feeding; HISPANIC Americans; HOSPITAL emergency services; INTENSIVE care units; LONGITUDINAL method; SCIENTIFIC observation; RESEARCH funding; BRONCHIOLE diseases; TREATMENT effectiveness; RETROSPECTIVE studies; RESPIRATORY aspiration; DATA analysis software; DESCRIPTIVE statistics; TERTIARY care; MANN Whitney U Test; NASAL cannula
- Publication
Respiratory Care, 2019, Vol 64, Issue 11, p1410
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.06352