Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia
American Journal of Pediatrics
Volume 6, Issue 3, September 2020, Pages: 182-189
Received: Mar. 15, 2020;
Accepted: Mar. 30, 2020;
Published: May 12, 2020
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Alayed Tareq, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Skaff Chahdah, Dr. Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
Alabdulsalam Moath, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Alturki Abdullah, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Aljofan Fahad, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Alanzi Fawaz, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Alofaisan Tareq, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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.
Pediatric High Flow Nasal Cannula Experience in a Tertiary Care Hospital in Saudi Arabia, American Journal of Pediatrics.
Vol. 6, No. 3,
2020, pp. 182-189.
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