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IS IT RIGHT TIME TO TAKE HUMIDIFIED HIGH FLOW NASAL CANNULA SERIOUSLY?
EP39306
Poster Title: IS IT RIGHT TIME TO TAKE HUMIDIFIED HIGH FLOW NASAL CANNULA SERIOUSLY?
Submitted on 24 Sep 2022
Author(s): Dr Daleep Meena, Dr Gurudutta
Affiliations: People Tree Hospital Bangalore India
This poster was presented at WFPICCS, Singapore 2018
Poster Views: 184
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Poster Information
Abstract:
Abstract title: IS IT RIGHT TIME TO TAKE HUMIDIFIED HIGH FLOW NASAL CANNULA SERIOUSLY?

Aims & Objectives:
HFNC is an emerging modality of therapy in critically ill children. Early initiation of HFNC for acute respiratory distress appears to reduce the need for invasive ventilation . Only few studies have reported on its clinical efficacy in Indian PICU setting.

Aims-To assess the efficacy and safety of HFNC admitted to PICU. To determine the rate of treatment failure and its predictors.

Methods:
Design-Prospective observational study
Study Duration-June 2017 to December 2017
Study Population and Setting-All consecutive patients (1 month to 18 years) who required HFNC for acute respiratory distress were admitted in tertiary care PICU. The clinical parameters, arterial blood gas and oxygen indices were evaluated at 0, 60min, 12 and 24 hours of presentation along with respiratory clinical score (RCS) and COMFORT scores. PIM III was used to calculate the death risk.

Results
We enrolled a total of 24 patients. Indications for HFNC were bronchiolitis (8), pneumonia (8), Dengue with pleural effusion (6), moderate ARDS (2) and seizure disorder (2). Mean HR,RR and saturations were148.3±27.19, 50.2±7.6 and 86.54 ±3.23 respectively on admission. 60 minutes after the commencement of HFNC mean HR ,RR, and O2 saturations improved to 137.9±21.79, 43.29±7.32 and 93.12±3.41.
Out of 18 children, 6 were weaned off at 12 hours and the remaining 12 were weaned off at 24 hours. 4(16.5%) patients failed to improve requiring invasive ventilation. RCS and COMFORT scores significantly improved whilst on HFNC.

Conclusions
HFNC improves RCS and COMFORT scores in diverse range of diagnoses causing respiratory failure. Treatment failure was not related to age, diverse diagnoses ,PIMIII score .


Summary: The HFNC therapy is efficient and well tolerated by
children with acute respiratory failure.

SPO2, FIO2, and respiratory score improvement in initial
2 hours may indicate treatment success.
References: References:
1 Spentzas T, Minarik M, Patters AB, Vinson B. Children with respiratory distress
treated with high-flow nasal cannula. Intensive Care Med 2009.
2 Pham TM, O’Malley L, Mayfield S, Martin S,SchiblerA The effect of high flow
nasal cannula therapy on the work of breathing in infants with bronchiolitis.Pediatr
Pulmonol 2014 .
3 Rubin S, Ghuman A, Deakers T, Khemani R, Ross P,Newth CJ. Effort ofbreathing
in children receiving high-flow nasal cannula. Pediatr Crit Care Med 2014
4Arzu Oto, Seher Erdoğan, Mehmet Boşnak Oxygen therapy via high flow nasal
cannula in PICU
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