![]() ![]() Resumir a literatura atual que descreve o uso da cânula nasal de alto fluxo em crianças, os componentes e mecanismos de ação do sistema de cânula nasal de alto fluxo, as aplicações clínicas adequadas e o papel desse sistema no departamento de emergência pediátrico. High-flow nasal cannula should be considered for pediatric emergency department patients with respiratory distress not requiring immediate endotracheal intubation prospective, pediatric emergency department-specific trials are needed to better determine responsive patient populations, ideal high-flow nasal cannula settings, and comparative efficacy vs. Patient characteristics, such as improved tachycardia and tachypnea, have been associated with a lack of progression to endotracheal intubation. Limited prospective interventional data suggest that high-flow nasal cannula may be similarly efficacious as continuous positive airway pressure and more efficacious than standard oxygen therapy for some patients. Introduction of high-flow nasal cannula into clinical practice, including in the emergency department, has been associated with decreased rates of endotracheal intubation. Most data describing high-flow nasal cannula use in children focuses on those with bronchiolitis, although high-flow nasal cannula has been used in children with other respiratory diseases. High-flow nasal cannula likely supports respiration though reduced inspiratory resistance, washout of the nasopharyngeal dead space, reduced metabolic work related to gas conditioning, improved airway conductance and mucociliary clearance, and provision of low levels of positive airway pressure. High-flow nasal cannula, a non-invasive respiratory support modality, provides heated and fully humidified gas mixtures to patients via a nasal cannula interface. SourcesĪ computer-based search of PubMed/MEDLINE and Google Scholar for literature on high-flow nasal cannula use in children was performed. Development of protocols for the initiation, escalation, and weaning of HFNC would optimize the utilization.īronchiolitis high-flow nasal cannula pediatric pediatric ICU status asthmaticus.Ĭopyright © 2017 by Daedalus Enterprises.To summarize the current literature describing high-flow nasal cannula use in children, the components and mechanisms of action of a high-flow nasal cannula system, the appropriate clinical applications, and its role in the pediatric emergency department. HFNC was utilized in 27% of all pediatric ICU admissions for a wide range of indications. Of the 63 subjects with congenital heart disease, 92% of the utilization was postextubation. HFNC was used as postextubation support in 16% of the subjects. 01) however, this was an older population, and peak oxygen concentration did not differ between the 2 groups (49.8% vs 47.1%, P =. When compared with all other respiratory viral illness, subjects with rhinovirus/enterovirus required a higher peak flow (14.9 L vs 13.1 L, P =. Respiratory viral infections were detected by polymerase chain reaction in 334 subjects managed with HFNC (53.8%) and included 260 subjects testing positive for rhinovirus/enterovirus. Of the subjects admitted with a primary diagnosis of status asthmaticus, 41% required management with terbutaline. ![]() Reported primary indications for the utilization of HFNC were status asthmaticus (24%), status asthmaticus with pneumonia (17%), and bronchiolitis (16%). The average age was 3.74 y (range 0-18.1 y), and subjects were 44% female and 65% African American. Over the enrollment study period, 620 subjects with HFNC were managed, which represented 27% of total ICU admissions. t test comparisons were used for comparison data. Descriptive statistics were used to describe demographics and utilization data. This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from Octoto October 31, 2013. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress.
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