High-flow nasal cannula in children with asthma exacerbation: A review of current evidence

Chao, Ke-Yun; Chien, Yu-Hsuan; Mu, Shu‐Chi

doi:10.1016/j.prrv.2021.01.003

Cited by 12 publications

(15 citation statements)

References 84 publications

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“…Many studies show that most patients are more comfortable with HFNC than a face mask 1–3,5 . A high flow system, depending on the size and type of nasal cannula, refers to flow rate ≥2 L/min (LPM) despite a range from 4 to 70 LPM 5,6 . HFNC is composed of a heated and humidified mixture of oxygen and airflow, which is greater than the inspiratory flow of the patient, so the patient can obtain fixed fraction of inspired oxygen (FiO 2 ) 6,7 .…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 , 3 , 5 A high flow system, depending on the size and type of nasal cannula, refers to flow rate ≥2 L/min (LPM) despite a range from 4 to 70 LPM. 5 , 6 HFNC is composed of a heated and humidified mixture of oxygen and airflow, which is greater than the inspiratory flow of the patient, so the patient can obtain fixed fraction of inspired oxygen (FiO 2 ). 6 , 7 In regard to respiratory support, HFNC has reported plenty of advantages to reduce the intubation and improve both oxygenation and ventilatory status.…”

Section: Introductionmentioning

confidence: 99%

“… 5 , 6 HFNC is composed of a heated and humidified mixture of oxygen and airflow, which is greater than the inspiratory flow of the patient, so the patient can obtain fixed fraction of inspired oxygen (FiO 2 ). 6 , 7 In regard to respiratory support, HFNC has reported plenty of advantages to reduce the intubation and improve both oxygenation and ventilatory status. 1 , 2 , 3 , 4 , 5 , 6 , 8 Previous studies have mentioned the mechanisms of HFNC including decreased inspiratory resistance, washout rebreathing of carbon dioxide gas, decreased metabolic work, maintaining positive airway pressure, and improving mucociliary clearance.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 In regard to respiratory support, HFNC has reported plenty of advantages to reduce the intubation and improve both oxygenation and ventilatory status. 1 , 2 , 3 , 4 , 5 , 6 , 8 Previous studies have mentioned the mechanisms of HFNC including decreased inspiratory resistance, washout rebreathing of carbon dioxide gas, decreased metabolic work, maintaining positive airway pressure, and improving mucociliary clearance. 1 , 4 , 6 , 8 , 9 , 10 , 11 , 12 , 13 Consequently, HFNC can improve oxygenation, reduce the respiratory rate, work of breathing, and endotracheal intubation rate.…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 , 3 , 4 , 5 , 6 , 8 Previous studies have mentioned the mechanisms of HFNC including decreased inspiratory resistance, washout rebreathing of carbon dioxide gas, decreased metabolic work, maintaining positive airway pressure, and improving mucociliary clearance. 1 , 4 , 6 , 8 , 9 , 10 , 11 , 12 , 13 Consequently, HFNC can improve oxygenation, reduce the respiratory rate, work of breathing, and endotracheal intubation rate. 14 , 15 , 16 On the other hand, some adverse effects of HFNC are air leak syndrome (pneumothorax and pneumomediastinum), nasal bleeding, noise emissions, abdominal distension, and delayed intubation.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with failure of using high flow nasal cannula in children

Sunkonkit

Kungsuwan

Seetaboot

et al. 2022

Clinical Respiratory J

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Introduction High flow nasal cannula (HFNC) has significantly success in treating acute respiratory distress while HFNC failure dramatically increases mortality and morbidity. Objective To describe factors associated with failure of HFNC use in children. Methods We performed a retrospective observational study using demographic and laboratory findings. We compared clinical and laboratory variables in both successful and failed HFNC groups. The correlations between factors and HFNC failure were constructed by binary logistic regression analysis. Results Between August 2016 and May 2018, 250 children receiving HFNC (median age 16 months; range 1–228 months, male 50.8%) were enrolled. Pneumonia was the most common cause of respiratory distress, and the median length of stay (LOS) in hospital was 11 days. HFNC failure was found 16.4% while HFNC complication was 4.8% including epistaxis, pressure sore, and gastric distension. Based on multivariable logistic regression analysis, factors associated with HFNC failure were children with congenital heart disease comorbidity (p = 0.005), HFNC use with maximum FiO2 > 0.6 (p = 0.021), lobar infiltration on chest X‐ray (p = 0.012), the reduction of heart rate, and respiratory rate <20% after 1 h of HFNC use (p = 0.001 and p = 0.001, respectively). Conclusion HFNC is feasible to use for children with respiratory distress; however, patients with congenital heart disease, using HFNC with FiO2 > 0.6, lobar infiltration on chest X‐ray should be closely monitored. Heart rate and respiratory rate are important parameters in addition to clinical assessment for evaluating HFNC failure in children.

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Section: Introductionmentioning

confidence: 99%