einstein (São Paulo). 02/Jun/2021;19:eAO5846.

High-flow nasal cannula failure: can clinical outcomes determine early interruption?

Milena Siciliano

Nascimento

, Danielle Eugênia Ribeiro

Quinto

, Gisele Cristina

Zamberlan

, Adriana Zamprônio dos

Santos

, Celso Moura

Rebello

, Cristiane do

Prado

DOI: 10.31744/einstein_journal/2021AO5846

ABSTRACT

Objective:

To evaluate the evolution of clinical outcomes in children with bronchiolitis who used a high-flow nasal cannula, and to determine after long of non-clinical improvement the therapy should be discontinued, and treatment should be escalated to other forms of ventilatory support.

Methods:

An observational retrospective study of infants with bronchiolitis who used a high-flow nasal cannula. Patients were divided into two study groups according to success or failure of high-flow nasal cannula therapy, namely the Success Group and the Failure Group. The main demographics and clinical variables were assessed 30 minutes and 6 hours after initiating therapy until removal of the high-flow nasal cannula.

Results:

A total of 83 children were studied and 18 children (21.7%) failed therapy. Among subjects with successful therapy, a significant decrease in respiratory rate (p<0.001), and a significant increase in peripheral oxygen saturation (p<0.001) were observed within 30 minutes. The Success Group was significantly different from the Failure Group after 6 hours, for both respiratory rate (p<0.01) and peripheral oxygen saturation (p<0.01).

Conclusion:

The absence of clinical sign improvement within 30 minutes and for up to a maximum of 6 hours can be considered as failure of the high-flow nasal cannula therapy. If this time elapses with no improvements, escalating to another type of ventilatory support should be considered.