Clinical Profile and Outcome of High Flow Nasal Cannula Therapy in Children with Acute Respiratory Distress: A Single Centre Retrospective Cohort Study from Southern India
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: High Flow Nasal Cannula (HFNC) therapy is being widely used as a treatment option for acute respiratory support prior to tracheal intubation or invasive ventilation. HFNC is a form of therapy in which high concentrations of oxygen, with adequate humidity and temperature, are administered non invasively via a nasal cannula. This approach has been shown to reduce airway resistance and improve lung compliance. While there are studies in Western literature regarding the efficacy of HFNC therapy in children in developed countries, there is still a paucity of data on the outcomes and efficacy of HFNC therapy in children in developing countries. Aim: To describe the clinical profile and outcomes of HFNC therapy in children admitted to a Paediatric Intensive Care Unit (PICU) with acute respiratory distress, as well as to identify the risk factors for failure of HFNC therapy in these children. Materials and Methods: This was a retrospective cohort study conducted by analysing the case records of children admitted with severe respiratory distress to the PICU of a tertiary care hospital in Southern India during the period from January 1, 2023, to December 31, 2023. The results were analysed over a threemonth period from January 1, 2024, to March 31, 2024. In this study, 55 children aged between one month and 18 years were included if they had received HFNC therapy for acute respiratory distress during the study period. Clinical and demographic data were collected and analysed with regard to the aetiology of acute respiratory distress, the indication for HFNC therapy, and the outcome. Results: During the study period, 55 (23.6%) of the 233 children admitted to the PICU required HFNC oxygen therapy for acute distress. Of these, 24 (43.6%) were children less than one year of age. The most common indication for HFNC therapy was bronchiolitis in acute respiratory distress (58.2%). In this study, 43 (78.2%) of the 55 children improved with HFNC; however, 12 children (21.8%) required escalation to invasive mechanical ventilation, which was considered a treatment failure. The reasons for treatment failures were analysed and found to include desaturation with worsening of the primary pathology and discontinuation of HFNC due to nasal discomfort, particularly in older children. Conclusion: This study concluded that HFNC therapy is beneficial, offering favourable outcomes and alleviating the need for more invasive forms of ventilation.
Authors: V Revathi, S Jagadeeswari, S Sundari
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $275
OpenAlex ID: W4409272012