Evaluation of pediatric patients treated with high-flow nasal cannula oxygen

Aim: The most important treatment step in acute respiratory failure is oxygen. High-flow nasal cannula oxygen therapy (HFNCO), which has previously been given in heated and humidified form to preterms, is now also being used as an oxygen delivery method for older children. In our study, we aimed to evaluate the effectiveness of the treatment, success of the treatment, and complications that developed in patients in the pediatric clinics, pediatric emergency room, and pediatric intensive care unit who received HFNCO treatment due to acute respiratory failure. Material and Methods: The study included 131 patients in the Çukurova University Faculty of Medicine between March 2018 and December 2019, who were hospitalized in the pediatric emergency department, pediatric clinics, or the pediatric intensive care unit and received HFNCO treatment. A data recording form was created to collect and prospectively analyze the information from the patients being studied. Demographic features of the patients, indication of HFNCO treatment, underlying chronic diseases, respiratory failure type, pediatric respiratory weight for the data recording form score (PRESS), the modified respiratory distress score (mRDAI) for patients with bronchiolitis, vital signs during treatment (respiratory rate, pulse, systolic and diastolic blood pressure, SpO2), SpO2 / FiO2 ratio, PaO2 / FiO2 ratio, blood-gas parameters, current rate and FiO2 value, medical treatments, treatment success, duration of treatment, length of hospital stay, developing complications, and mortality were recorded. Results: A total of 131 patients, 66 (50.4%) girls and 65 (49.6%) boys, were included in our study. Mean ages were 50.9 ± 58.5 months and mean body weights were 13.5 ± 9.93 kg. The most common indication for HFNCO treatment was pneumonia (n = 75, 57.3%). Overall, 85.5% (n =112) of the patients had an underlying chronic disease, with the most common being congenital heart disease (22.9%; n = 30). Most patients had type 1 respiratory failure (69.5%; n = 91). None of our patients needed sedation or analgesics, and 88.5% (n = 116) had successful results. During HFNCO treatment, significant changes were observed in pulse, respiratory rate, SpO2, and SpO2 / FiO2 from the first hour (p < 0.05). Local skin lesions were observed in 2 (1.7%) patients and abdominal distention in 2 (1.7%) patients. None of our patients died during the treatment. Conclusion: It has been observed that the use of HFNCO therapy in the pediatric age group has become increasingly widespread in recent years. The HFNCO system is a non-invasive, simple, effective, and easy-to-use oxygen delivery method. However, additional comprehensive, randomized and controlled studies are needed to more precisely determine its reliability and effectiveness.