Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 5 ( 2018 ) > List of Articles

RESEARCH ARTICLE

High-flow nasal cannula versus conventional oxygen therapy in children with respiratory distress

Punthila Sitthikarnkha, Rujipat Samransamruajkit, Nuanchan Prapphal, Jitladda Deerojanawong, Suchada Sritippayawan

Keywords : Children, conventional oxygen, high flow nasal cannula, intubation, respiratory distress

Citation Information : Sitthikarnkha P, Samransamruajkit R, Prapphal N, Deerojanawong J, Sritippayawan S. High-flow nasal cannula versus conventional oxygen therapy in children with respiratory distress. Indian J Crit Care Med 2018; 22 (5):321-325.

DOI: 10.4103/ijccm.IJCCM_181_17

License: CC BY-ND 3.0

Published Online: 01-01-2015

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Purpose: The aim of this study is to determine the clinical efficacy of high-flow nasal cannula (HFNC) therapy compared with conventional oxygen therapy in children presented with respiratory distress. Study Design: This was a randomized controlled study. Materials and Methods: Infants and children aged between 1 month to 5 years who were admitted to our tertiary referral center for respiratory distress (July 1, 2014 to March 31, 2015) and met the inclusion criteria were recruited. Interventions: Infants and children hospitalized with respiratory distress were randomized into two groups of interventions. All clinical data, for example, respiratory score, pulse rate, and respiratory rate were recorded. The results were subsequently analyzed. Results: A total of 98 respiratory distress children were enrolled during the study period. Only 4 children (8.2%) failed in HFNC therapy, compared with 10 children (20.4%) in conventional oxygen therapy group (P = 0.09). After adjusted for body weight, underlying diseases, and respiratory distress score, there was an 85% reduction in the odds of treatment failure in HFNC therapy group (adjusted odds ratio 0.15, 95% confidence interval 0.03–0.66, P = 0.01). Most children in HFNC therapy group had significant improvement in clinical respiratory score, heart rate, and respiratory rate at 240, 360, and 120 min compared with conventional oxygen therapy (P = 0.03, 0.04, and 0.03). Conclusion: HFNC therapy revealed a potential clinical advantage in management children hospitalized with respiratory distress compared with conventional respiratory therapy. The early use of HFNC in children with moderate-to-severe respiratory distress may prevent endotracheal tube intubation. Trial Register: TCTR 20170222007.


PDF Share
  1. Richards AM. Pediatric respiratory emergencies. Emerg Med Clin North Am 2016;34:77-96.
  2. Nath P, Ponnusamy V, Willis K, Bissett L, Clarke P. Current practices of high and low flow oxygen therapy and humidification in UK neonatal units. Pediatr Int 2010;52:893-4.
  3. Ramanathan R. Nasal respiratory support through the nares: Its time has come. J Perinatol 2010;30 Suppl:S67-72.
  4. Schlapbach LJ, Schaefer J, Brady AM, Mayfield S, Schibler A. High-flow nasal cannula (HFNC) support in interhospital transport of critically ill children. Intensive Care Med 2014;40:592-9.
  5. Roca O, Riera J, Torres F, Masclans JR. High-flow oxygen therapy in acute respiratory failure. Respir Care 2010;55:408-13.
  6. Spence KL, Murphy D, Kilian C, McGonigle R, Kilani RA. High-flow nasal cannula as a device to provide continuous positive airway pressure in infants. J Perinatol 2007;27:772-5.
  7. Dysart K, Miller TL, Wolfson MR, Shaffer TH. Research in high flow therapy: Mechanisms of action. Respir Med 2009;103:1400-5.
  8. ten Brink F, Duke T, Evans J. High-flow nasal prong oxygen therapy or nasopharyngeal continuous positive airway pressure for children with moderate-to-severe respiratory distress?. Pediatr Crit Care Med 2013;14:e326-31.
  9. Wraight TI, Ganu SS. High-flow nasal cannula use in a paediatric Intensive Care Unit over 3 years. Crit Care Resusc 2015;17:197-201.
  10. Cherian S, Morris I, Evans J, Kotecha S. Oxygen therapy in preterm infants. Paediatr Respir Rev 2014;15:135-41.
  11. McKiernan C, Chua L, Visintainer P, Allen H. High flow nasal cnnulas therapy in infants with acute bronchiolitis. J Pediatr 2010;156:634-8.
  12. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 2015;372:2185-96.
  13. Testa G, Iodice F, Ricci Z, Vitale V, De Razza F, Haiberger R, et al. Comparative evaluation of high-flow nasal cannula and conventional oxygen therapy in paediatric cardiac surgical patients: A randomized controlled trial. Interact Cardiovasc Thorac Surg 2014;19:456-61.
  14. Schibler A, Pham TM, Dunster KR, Foster K, Barlow A, Gibbons K, et al. Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Med 2011;37:847-52.
  15. Bernadette T. Clinical Guidelines (nursing): High Flow Nasal Prong (HFNC) Therapy; 2014. Available from: http://www.rch.org.au/rchcpg/hospital_clinicalguideline_index/highflownasalprong. [Last accessed on 2016 Dec].
  16. Wing R, James C, Maranda LS, Armsby CC. Use of high-flow nasal cannula support in the emergency department reduces the need for intubation in pediatric acute respiratory insufficiency. Pediatr Emerg Care 2012;28:1117-23.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.