A nationwide survey on the use of heated humidified high flow oxygen therapy on the paediatric wards in the UK: current practice and research priorities

Hosheh, Osama; Edwards, Christopher T; Ramnarayan, Padmanabhan

doi:10.1186/s12887-020-1998-1

Cited by 16 publications

(9 citation statements)

References 28 publications

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“…In these studies, a beneficial role for the use of HFNC in the general pediatric ward to prevent of PICU admissions is suggested (19, 20), but the effectiveness of preventing PICU admission and intubation rates is under discussion [ 19 , 20 ]. A recent survey in the UK indicated however that treating pediatricians prefer HFNC over CPAP as being more effective with fewer complications [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

et al. 2021

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Respiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known:• RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission.• The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New:• The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies.• There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.

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Section: Discussionmentioning

confidence: 99%

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

et al. 2021

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“…However, CPAP has high skill requirements for nurses as the improper use would lead to adverse outcomes including nasal mucosal injury or necrosis, nasal granuloma, nasal vestibular stenosis, and nasal septum deformation or deletion in infants, and the special caps that needs to be worn for fixation to ensure ventilation effect would add discomfort for infants (2,5,6). High-flow Nasal Cannula Oxygen Therapy (HFNC), also known as Heated Humidified High Flow Nasal Cannula (HHHFNC), is a newly emerged non-invasive respiratory support technology and has been increasingly applied in NICU as an alternative to CPAP (1,(7)(8)(9)(10)(11)(12)(13). Compared with CPAP, HFNC has several merits in promoting alveolar dilation (14)(15)(16)(17)(18), improving gas exchange (14,19), protecting airway mucosa (20), and reducing respiratory work (19).…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula versus continuous positive airway pressure in primary respiratory support for preterm infants: A systematic review and meta-analysis

Luo

Huang²,

Xiong³

et al. 2022

Front. Pediatr.

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Respiratory support is crucial for the survival of preterm infants, and High-flow Nasal Cannula Oxygen Therapy (HFNC) and Continuous Positive Airway Pressure (CPAP) are commonly used for neonatal respiratory support. This meta-analysis aimed to compare the effects of HFNC and CPAP in primary respiratory support for preterm infants, to provide evidence-based support for clinical practice. PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, VIP, WANFANG and SinoMed were searched for eligible studies. The primary outcomes included the incidence of treatment failure and the application of mechanical ventilation. A total of 27 eligible studies with 3,351 participants were included. There was no significant difference in the incidence of respiratory support failure [RR = 1.17, 95%CI (0.88–1.56)] and the application of mechanical ventilation [RR = 1.00, 95%CI (0.84–1.19)] between HFNC group and CPAP group. HFNC resulted in lower rate of air leaks [RR = 0.65, 95%CI (0.46–0.92)], nasal trauma [RR = 0.36, 95%CI (0.29–0.45)] and abdominal distension [RR = 0.39, 95%CI (0.27–0.58)], and later time of mechanical ventilation initiating [SMD = 0.60, 95%CI (0.21–0.99)], less duration of oxygen therapy [SMD = −0.35, 95%CI (−0.68 to −0.02)] and earlier enteral feeding [SMD = −0.54, 95%CI (−0.95 to −0.13)]. Alternative non-invasive respiratory support after initial treatment failure resulted in no difference in the application of mechanical ventilation between the two groups [RR = 0.99, 95%CI (0.52–1.88)]. HFNC might be more effective and safer in primary respiratory support for preterm infants. Using CPAP as a remedy for the treatment failure of HFNC could not avoid intubation. For premature infants with the gestational age <28 weeks, HFNC as primary respiratory support still needs to be further elucidated.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022313479, identifier: CRD42022313479.

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“…High-flow nasal cannula (HFNC) oxygen therapy has been a popular type of noninvasive respiratory support, widely used in NICUs because it is comfortable, easy to setup, and has a low incidence of nasal trauma. [7][8][9][10][11][12][13] There is an increasing number of studies on the advantages, indications, and risks of using HFNC in neonates, as well as comparing its effectiveness with that of NCPAP and other noninvasive ventilation modes. However, uncertainty surrounding the use of HFNC in the NICU remains, and cultural differences in China regarding the preferences and values of Chinese parents bring up the necessity to develop HFNC guidelines that consider Chinese culture.…”

mentioning

confidence: 99%

Guidelines for high‐flow nasal cannula oxygen therapy in neonates (2022)

Huang,

Zhao,

Hua

et al. 2023

J Evidence Based Medicine

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High‐flow nasal cannula (HFNC) oxygen therapy, which is important in noninvasive respiratory support, is increasingly being used in critically ill neonates with respiratory failure because it is comfortable, easy to setup, and has a low incidence of nasal trauma. The advantages, indications, and risks of HFNC have been the focus of research in recent years, resulting in the development of the application. Based on current evidence, we developed guidelines for HFNC in neonates using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The guidelines were formulated after extensive consultations with neonatologists, respiratory therapists, nurse specialists, and evidence‐based medicine experts. We have proposed 24 recommendations for 9 key questions. The guidelines aim to be a source of evidence and reference of HFNC oxygen therapy in clinical practice, and so that more neonates and their families will benefit from HFNC.

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A nationwide survey on the use of heated humidified high flow oxygen therapy on the paediatric wards in the UK: current practice and research priorities

Cited by 16 publications

References 28 publications

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

High-flow nasal cannula versus continuous positive airway pressure in primary respiratory support for preterm infants: A systematic review and meta-analysis

Guidelines for high‐flow nasal cannula oxygen therapy in neonates (2022)

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