American Journal of Pediatrics

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Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia

Received: 15 March 2020    Accepted: 30 March 2020    Published: 12 May 2020
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Abstract

Acute respiratory failure, being a significant problem in Pediatric intensive care units, always requires support, whether via invasive or non-invasive devices. High flow nasal cannula, a relatively new machine, has multiple favorable physiological effects when used for respiratory distressed patients. It is currently widely applied in multiple settings, including PICU. This study describes the experience of HFNC use in a tertiary care hospital in Saudi Arabia. The primary outcome of interest was the intubation rate. The secondary outcomes were mortality rate and length of stay in the pediatric intensive care unit. Moreover, we compared these outcomes between two groups of patients: immunocompromised and immunocompetent patients. Four hundred thirteen patients were included. 45.5% admitted due to pneumonia. 24.6% of patients required intubation with an interval time between the initiation of HFNC and intubation being 40 hours (hrs.). The mortality rate was 17%, and the mean length of stay in PICU was 12 days. One hundred thirty six (35%) patients were immunocompromised. The majority admitted because of pneumonia (70%). There was a significant statistical difference in the rate of intubation (35.5% vs. 25%, P-value 0.03) and mortality (39% vs. 5.5% with a p-value of <0.0001) between the two groups. However, when comparing the mortality rate in the immunocompromised patients only, 81.6% were intubated compared to 14.6% required only HFNC (p < 0.05). HFNC seems to be beneficial and tolerable to pediatric populations. Although the immunocompromised patients showed expected higher mortality and intubation rate compared to the non-immunocompromised, the sub-analysis showed that those who required only HFNC had a better survival rate.

DOI 10.11648/j.ajp.20200603.13
Published in American Journal of Pediatrics (Volume 6, Issue 3, September 2020)
Page(s) 182-189
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

High Flow Nasal Cannula, Pediatric, PICU, Immunocompromised Patient

References
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Author Information
  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

  • Dr. Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia

  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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  • APA Style

    Alayed Tareq, Skaff Chahdah, Alabdulsalam Moath, Alturki Abdullah, Aljofan Fahad, et al. (2020). Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia. American Journal of Pediatrics, 6(3), 182-189. https://doi.org/10.11648/j.ajp.20200603.13

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    ACS Style

    Alayed Tareq; Skaff Chahdah; Alabdulsalam Moath; Alturki Abdullah; Aljofan Fahad, et al. Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia. Am. J. Pediatr. 2020, 6(3), 182-189. doi: 10.11648/j.ajp.20200603.13

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    AMA Style

    Alayed Tareq, Skaff Chahdah, Alabdulsalam Moath, Alturki Abdullah, Aljofan Fahad, et al. Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia. Am J Pediatr. 2020;6(3):182-189. doi: 10.11648/j.ajp.20200603.13

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  • @article{10.11648/j.ajp.20200603.13,
      author = {Alayed Tareq and Skaff Chahdah and Alabdulsalam Moath and Alturki Abdullah and Aljofan Fahad and Alanzi Fawaz and Alofaisan Tareq},
      title = {Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {3},
      pages = {182-189},
      doi = {10.11648/j.ajp.20200603.13},
      url = {https://doi.org/10.11648/j.ajp.20200603.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajp.20200603.13},
      abstract = {Acute respiratory failure, being a significant problem in Pediatric intensive care units, always requires support, whether via invasive or non-invasive devices. High flow nasal cannula, a relatively new machine, has multiple favorable physiological effects when used for respiratory distressed patients. It is currently widely applied in multiple settings, including PICU. This study describes the experience of HFNC use in a tertiary care hospital in Saudi Arabia. The primary outcome of interest was the intubation rate. The secondary outcomes were mortality rate and length of stay in the pediatric intensive care unit. Moreover, we compared these outcomes between two groups of patients: immunocompromised and immunocompetent patients. Four hundred thirteen patients were included. 45.5% admitted due to pneumonia. 24.6% of patients required intubation with an interval time between the initiation of HFNC and intubation being 40 hours (hrs.). The mortality rate was 17%, and the mean length of stay in PICU was 12 days. One hundred thirty six (35%) patients were immunocompromised. The majority admitted because of pneumonia (70%). There was a significant statistical difference in the rate of intubation (35.5% vs. 25%, P-value 0.03) and mortality (39% vs. 5.5% with a p-value of <0.0001) between the two groups. However, when comparing the mortality rate in the immunocompromised patients only, 81.6% were intubated compared to 14.6% required only HFNC (p < 0.05). HFNC seems to be beneficial and tolerable to pediatric populations. Although the immunocompromised patients showed expected higher mortality and intubation rate compared to the non-immunocompromised, the sub-analysis showed that those who required only HFNC had a better survival rate.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia
    AU  - Alayed Tareq
    AU  - Skaff Chahdah
    AU  - Alabdulsalam Moath
    AU  - Alturki Abdullah
    AU  - Aljofan Fahad
    AU  - Alanzi Fawaz
    AU  - Alofaisan Tareq
    Y1  - 2020/05/12
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200603.13
    DO  - 10.11648/j.ajp.20200603.13
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 182
    EP  - 189
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200603.13
    AB  - Acute respiratory failure, being a significant problem in Pediatric intensive care units, always requires support, whether via invasive or non-invasive devices. High flow nasal cannula, a relatively new machine, has multiple favorable physiological effects when used for respiratory distressed patients. It is currently widely applied in multiple settings, including PICU. This study describes the experience of HFNC use in a tertiary care hospital in Saudi Arabia. The primary outcome of interest was the intubation rate. The secondary outcomes were mortality rate and length of stay in the pediatric intensive care unit. Moreover, we compared these outcomes between two groups of patients: immunocompromised and immunocompetent patients. Four hundred thirteen patients were included. 45.5% admitted due to pneumonia. 24.6% of patients required intubation with an interval time between the initiation of HFNC and intubation being 40 hours (hrs.). The mortality rate was 17%, and the mean length of stay in PICU was 12 days. One hundred thirty six (35%) patients were immunocompromised. The majority admitted because of pneumonia (70%). There was a significant statistical difference in the rate of intubation (35.5% vs. 25%, P-value 0.03) and mortality (39% vs. 5.5% with a p-value of <0.0001) between the two groups. However, when comparing the mortality rate in the immunocompromised patients only, 81.6% were intubated compared to 14.6% required only HFNC (p < 0.05). HFNC seems to be beneficial and tolerable to pediatric populations. Although the immunocompromised patients showed expected higher mortality and intubation rate compared to the non-immunocompromised, the sub-analysis showed that those who required only HFNC had a better survival rate.
    VL  - 6
    IS  - 3
    ER  - 

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