Abstract
Introduction. The high-flow nasal cannula (HFNC) is an increasingly widespread type of respiratory support highly used in infants with bronchiolitis.
Objective. To evaluate the effectiveness, security and tolerance of the HFNC used in infants with bronchiolitis who were transferred by a pediatric interhospital transport team.
Methods. This is an effectiveness study before-after the introduction of HFNC in the pediatric transport of children with moderate to severe bronchiolitis. Clinical variables and escalation to a higher level of respiratory support were recorded in two statistically comparable groups of patients corresponding with the inclusion criteria: 66 children collected in the previous year of the introduction of the HFNC (2011-2012), compared with 74 children who were transferred during the next year after introducing the HFNC therapy at the pediatric transport service (2012-2013).
Results. Significant statistical differences were found in the type of respiratory support used during the transports; in 2011-12 a higher use of CPAP or MV was necessary, compared to that of 2012-13 (39.4% vs 16.2%, p=0.02).
Significant statistical differences were found in heart rate between the two study periods, with moderate effect size (mean difference 2012-13/2011-12= -18.2, Effect size= 0.62, T <0.001).
No adverse effects were observed due to the HFCN during the transport of all patients and tolerance was excellent.
Conclusions. A significant decrease in the CPAP use has been observed after the introduction of the HFCN, which seems to be better tolerated and non inferior in terms of effectiveness to other forms of non-invasive respiratory support used in our pediatric transport team.
- © 2014 ERS