The Effectiveness of Heated Humidified High-flow Nasal Cannula in Children with Severe Bacterial Pneumonia in the Emergency Department
Journal Title: The Journal of Pediatric Research - Year 2020, Vol 7, Issue 1
Abstract
Aim: The provision of appropriate respiratory support has a great role in outcome of patients presenting to the emergency department (ED) with respiratory distress (RD) associated with severe pneumonia. In recent years, heated humidified high-flow nasal cannula (HHHFNC) therapy has become one of the most popular non-invasive respiratory support modalities in all pediatric settings. In this study, we aimed to assess whether the use of HHHFNC therapy is associated with reduced RD and improvements in hypoxemia among children with severe bacterial pneumonia (SBP) presenting to the ED. Materials and Methods: We performed a prospective observational study of patients with SBP admitted to a tertiary children’s hospital pediatric ED who received HHHFNC therapy within the 2 year study period. The primary outcome was accepted as treatment failure (It was defined as a clinical escalation in respiratory status) and an increase in peripheral capillary oxygen saturation (SpO2). Secondary outcomes covered a decrease of respiratory rate (RR), heart rate (HR), and rates of weaning, intubation and intensive care unit (ICU) admission. Results: Fifty-six patients were included in this analyses. Treatment failure was 21.5% (12/56). Among these patients, 9 (16%) were intubated and 3 (5.5%) placed on bilevel positive airway pressure. The mean initial RR values were significantly higher in the non responders group than the responder group (p=0.027). Significant variation in the intubation rate or the ICU admission rate was not determined. At the 2nd hour, the fall in RR (p<0.001), HR (p<0.001), and the increase of SpO2 (p<0.001) were significantly evident when compared with the beginning. Conclusion: HHHFNC therapy reached treatment success in a majority of the patients with SBP and provided an early effect. Patients with higher RRs responded less to HHHFNC. Further larger studies are needed to assess the impact of HHHFNC compared with other possible therapies.
Authors and Affiliations
Ali Yurtseven, Eylem Ulaş Saz
Keywords
Related Articles
- EP ID EP685473
- DOI 10.4274/jpr.galenos.2019.15045
- Views 152
- Downloads 0
Diagnostic Evaluation of Foreign Body Aspiration in Children
Aim: The aim of this study was to evaluate the place of clinical symptoms and findings, and radiological imaging in the diagnosis of foreign body aspiration (FBA) in children, and to investigate the validity of existing...
Administration of a Second Dose Antivenom in the Early Period: Is It Effective in Scorpion Stings?
Aim: It has been known for years that the toxic effects of scorpion envenomation can be fatal. Scorpion antivenom administration reduces the severity of systemic toxicity and fatal complications resulting from envenomati...
Investigation of the Relationship between Physical Activity and Body Mass Index in Children with Down Syndrome
Aim: This study aimed was to investigate the relationship between physical activity levels and the Body Mass index (BMI) of children with Down syndrome (DS). Materials and Methods: This study included 26 children (15 ma...
The Impact of e-Health Literacy on Health Promotion Behaviors of High School Students
Aim: The aim of this study was to investigate the effects of e-health literacy on health promotion behaviors on high school students. Materials and Methods: This descriptive, cross-sectional and relational study was con...
The Prevalence of Sports-related Dental Injuries and the Rate of Awareness of Mouthguard Use among Child Athletes
Aim: Sport activities are among the most important causes of dental injuries. The prevalence of dental injuries is higher in children and in contact sports and the use of mouthguards can reduce their incidence. The goal...