Early predictors of unresponsiveness to high‐flow nasal cannula therapy in a pediatric emergency department

Abstract

The low initial SpO and SF ratio, respiratory acidosis, and SF ratio less than 195 at the first hours of treatment were related to unresponsiveness to HFNC therapy in our pediatric emergency department.

Comparison of heated humidified high‐flow nasal cannula flow rates (1‐L·kg·min−1 vs 2‐L·kg·min−1) in the management of acute bronchiolitis

“…However, some questions such as “which dose should be preferred for infants with bronchiolitis?” about this respiratory support modality still have not found an answer . Although previously the 1‐L·kg·min −1 flow rate or 4 to 8 L/min flow rate was frequently used in patients with bronchiolitis, currently most centers choose the 2‐L·kg·min −1 flow rate . But this modification is based on only a few physiological studies, and there still has been no satisfactory clinical data to determine the optimal flow rate required for clinical benefit …”

High‐flow Oxygen Therapy for Treating Bronchiolitis in Infants

“…Therefore, a trial originated exclusively in the ED might produce different results. Er et al . explored the characteristics of ED patients with bronchiolitis who respond poorly to high‐flow oxygen therapy.…”

Safety and Efficacy of High-flow Nasal Cannula Therapy in the Pediatric Emergency Department

“…Study design, outcome and key results are summarized in Table 1. Seven studies included only children with bronchiolitis [16][17][18][19][20][21][22] , six studies had children with respiratory distress due to any disease [23][24][25][26][27][28] and one study was on children with acute asthma exacerbations. 29 Five studies enrolled children up to 24 months of age 19,20,22,24,27 , four enrolled children up to 18 years of age 23,25,26,28 , four included children up to 12 months of age only [16][17][18]21 , and one enrolled children aged 1 to 14 years.…”

“…Seven studies included only children with bronchiolitis [16][17][18][19][20][21][22] , six studies had children with respiratory distress due to any disease [23][24][25][26][27][28] and one study was on children with acute asthma exacerbations. 29 Five studies enrolled children up to 24 months of age 19,20,22,24,27 , four enrolled children up to 18 years of age 23,25,26,28 , four included children up to 12 months of age only [16][17][18]21 , and one enrolled children aged 1 to 14 years. 29 In five studies, HFNC devices were used with 2 L/kg/min flow rate for infants or children up to 10 kg 17,21,25,28,29 , five studies did not report a specific flow rate 18,20,24,26,27 , in one study, 1 L/ kg/min flow rate was utilized 19 and in one study, both 1 L/kg/ min flow rate and 2 L/kg/min were used.…”

“…29 Five studies enrolled children up to 24 months of age 19,20,22,24,27 , four enrolled children up to 18 years of age 23,25,26,28 , four included children up to 12 months of age only [16][17][18]21 , and one enrolled children aged 1 to 14 years. 29 In five studies, HFNC devices were used with 2 L/kg/min flow rate for infants or children up to 10 kg 17,21,25,28,29 , five studies did not report a specific flow rate 18,20,24,26,27 , in one study, 1 L/ kg/min flow rate was utilized 19 and in one study, both 1 L/kg/ min flow rate and 2 L/kg/min were used. 22 In another study a flow rate of 1-8 L/min was used 16 , and in the last study a flow rate of 4-10 L/min was used for children younger than 24 months of age and 5-50 L/min flow rates in older children.…”