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Preemptive high‐flow nasal cannula treatment in severe bronchiolitis: Results from a high‐volume, resource‐limited pediatric emergency department
Author(s) -
Kamit Fulya,
Anil Murat,
Anil Ayse Berna,
Berksoy Emel,
Gokalp Gamze
Publication year - 2020
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14325
Subject(s) - medicine , nasal cannula , bronchiolitis , emergency department , emergency medicine , anesthesia , tachycardia , cannula , intensive care medicine , surgery , respiratory system , psychiatry
Abstract Background The aims of this study were to evaluate the outcomes of patients with severe bronchiolitis who received preemptive high‐flow nasal cannula (HFNC) treatment according to the authors’ protocol, and to identify potential baseline characteristics that might predict patients who will not benefit from HFNC. Methods This was a retrospective chart review of patients with severe bronchiolitis, who received preemptive HFNC treatment according to the authors’ protocol and who were admitted to the pediatric emergency department between January 1, 2015, and December 31, 2016. Results Eighty‐four patients in total were enrolled over the 2 year period. Twenty‐three patients (27.3%) failed HFNC. Of these, four responded to non‐invasive mechanical ventilation and 19 required subsequent invasive ventilation. According to logistic regression analysis, existence of a chronic condition, significant tachycardia, existence of dehydration, and a venous pH <7.30 at admission were found to be predictors of HFNC failure. There were no cases of pneumothorax or any other reported adverse effects related to HFNC therapy. Conclusions Preemptive HFNC treatment, complying with a preestablished protocol, might be a safe way to support patients with severe bronchiolitis in high‐volume, resource‐limited pediatric emergency departments. The existence of a chronic condition, significant tachycardia, dehydration, and a venous pH <7.30 at admission could be risk factors for preemptive HFNC treatment failure in severe bronchiolitis.