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Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit

Yıl 2022, Cilt: 6 Sayı: 1, 7 - 14, 22.04.2022

Osman Büyükşen Süleyman Bayraktar Murat Elevli

https://doi.org/10.46332/aemj.883605

Öz

Purpose: One of the respiratory supports in acute respiratory failure (ARF) is high-flow nasal cannula (HFNC) oxygen therapy, which is being increasingly used in this study. We aimed to evaluate the patients with ARF who received HFNC oxygen therapy in the pediatric intensive care unit (ICU).
Materials and Methods: The study was done retrospectively in 104 patients who were admitted to the pediatric ICU and received HFNC oxygen therapy between January 2015 and December 2017.
Results: The median age of the patients participating in the study was 5 months. The most common cause of hospitalization was lower respiratory disease (97.1%), and 52.9% of the patients had type 1 respiratory failure. The median length of stay in the pediatric ICU was 7 days, while the median duration of HFNC oxygen therapy was 48 hours. In patients who were intubated during HFNC oxygen therapy (28.8%), the proportions of having a chronic disease and chronic lung disease were significantly higher than those who were not intubated (p=0.001, p=0.033, respectively). In terms of complications, nasal skin damage (8.7%) and pneumothorax (1.9%) were developed. The proportions of chronic diseases and congenital heart disease of the patients who were admitted to pediatric ICU and died after HFNC oxygen therapy were significantly higher than the survivors (p=0.043, p=0.003, respectively).
Conclusion: The results of HFNC oxygen therapy, which is being increasingly used in the treatment of respiratory failure in children, are generally satisfactory. However, due to possible complications, close monitoring is required during the application.

Anahtar Kelimeler

child Pediatric intensive care unit Respiratory failure oxygen therapy

Kaynakça

  • 1. Mayfield S, Jauncey-Cooke J, Hough JL, Schibler A, Gibbons K, Bogossian F. High-flow nasal cannula therapy for respiratory support in children. Cochrane Database Syst Rev. 2014;2014(3):CD009850.
  • 2. Söğütlü Y, Biçer S, Kurt G, ve ark. Alt solunum yolu hastalığı olan çocuklarda yüksek akımlı nazal kanül oksijenasyon tedavisinin yaşamsal bulgular üzerindeki sonuçları. J Pediatr Emerg Intensive Care Med. 2016;3(3):121-130.
  • 3. Wing R, James C, Maranda LS, Armsby CC. Use of high-flow nasal cannula support in the emergency department reduces the need for intubation in pediatric acute respiratory insufficiency. Pediatr Emerg Care. 2012;28(11):1117-1123.
  • 4. Lee JH, Rehder KJ, Williford L, Cheifetz IM, Turner DA. Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature. Intensive Care Med. 2013;39(2):247-257.
  • 5. Slain KN, Shein SL, Rotta AT. The use of high-flow nasal cannula in the pediatric emergency department. J Pediatr (Rio J). 2017;93(1):36-45.
  • 6. Mikalsen IB, Davis P, Øymar K. High flow nasal cannula in children: a literature review. Scand J Trauma Resusc Emerg Med. 2016;24(1):1-12.
  • 7. Kezer S, Eryavuz Ö, Okuyan H. E, Atakan S. K, Mutlu D, Demirkol D. solunum yetersizliğinde yüksek akımlı oksijen tedavisi. Pediatri. 2018;10(3):12-18.
  • 8. Friedman ML, Nitu ME. Acute respiratory failure in children. Pediatr Ann. 2018;47(7):268-273.
  • 9. Köksoy ÖT, Paksu MŞ, Yener N, Kaplan EM. Çocuk yoğun bakım ünitesinde invaziv olmayan mekanik ventilasyon uygulanan hastaların geriye dönük değerlendirilmesi. J Pediatr Emerg Intensive Care Med. 2016;3(2):62-68.
  • 10. Hasani A, Chapman TH, McCool D, Smith RE, Dilworth JP, Agnew JE. Domiciliary humidification improves lung mu-cociliary clearance in patients with bronchiectasis. Chron Respir Dis. 2008;5(2):81-86.
  • 11. Rea H, McAuley S, Jayaram L, et al. The clinical utility of long-term humidification therapy in chronic airway disease. Respir Med. 2010;104 (4):525-533.
  • 12. Dysart K, Miller TL, Wolfson MR, Shaffer TH. Research in high flow therapy: mechanisms of action. Respir Med. 2009;103(10):1400-1405.
  • 13. Masip J, Roque M, Sánchez B, Fernández R, Subirana M, Expósito JA. Noninvasive ventilation in acute cardiogenic pulmonary edema:systematic review and meta-analysis. JAMA. 2005;294(24):3124-3130.
  • 14. Milési C, Boubal M, Jacquot A, et al. High-flow nasal cannula: recommendations for daily practice in pediatrics. Ann Intensive Care. 2014;4(1):1-7.
  • 15. Oto A, Erdogan S, Bosnak M. Oxygen therapy via high flow nasal cannula in pediatric intensive care unit. Turk J Pedi-atr. 2016;58(4):377-382.
  • 16. Roca O, Riera J, Torres F, Masclans JR. High-flow oxygen therapy in acute respiratory failure. Respir Care. 2010;55(4):408-413.
  • 17. Testa G, Iodice F, Ricci Z, et al. Comparative evaluation of high-flow nasal cannula and conventional oxygen therapy in paediatric cardiac surgical patients: a randomized controlled trial. Interact Cardiovasc Thorac Surg. 2014;19(3):456-461.
  • 18. Çapan K, Apaydın HO, Geyik M. Yüksek akımlı nazal kanül oksijenasyon tedavisine bağlı pnömotoraks olgusu. J Pe-diatr Emerg Intensive Care Med. 2017;4(2):80-83.
  • 19. Schwabbauer N, Berg B, Blumenstock G, Haap M, Hetzel J, Riessen R. Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxy-gen therapy and non-invasive ventilation (NIV). BMC Anesthesiol. 2014;14(1):1-7.
  • 20. Yurtseven A, Saz EU. The effectiveness of heated humidified high-flow nasal cannula in children with severe bacterial pneumonia in the emergency department. J Pediatr Res. 2020;7(1):1-7.
  • 21. Baudin F, Buisson A, Vanel B, Massenavette B, Pouyau R, Javouhey E. Nasal high flow in management of children with status asthmaticus: a retrospective observational study. Ann Intensive Care. 2017;7(1):1-9.
  • 22. Hegde S, Prodhan P. Serious air leak syndrome complicating high-flow nasal cannula therapy: a report of 3 cases. Pedi-atrics. 2013;131(3):939-944.
  • 23. Fleeman N, Mahon J, Bates V, et al. The clinical effectiveness and cost-effectiveness of heated humidified highflow na-sal cannula compared with usual care for preterm infants: systematic review and economic evaluation. Health Technol Assess. 2016;20(30):1-68.
  • 24. Lin J, Zhang Y, Xiong L, Liu S, Gong C, Dai J. High-flow nasal cannula therapy for children with bronchiolitis: a sys-tematic review and meta-analysis. Arch Dis Child. 2019;104(6):564-576.
  • 25. Kawaguchi A, Yasui Y, deCaen A, Garros D. The clinical ımpact of heated humidified high-flow nasal cannula on pedi-atric respiratory distress. Pediatr Crit Care Med. 2017;18(2):112-119.

Çocuk Yoğun Bakım Ünitesinde Yüksek Akımlı Nazal Kanül Oksijen Tedavisi Alan Has-taların Klinik ve Epidemiyolojik Özelliklerinin Değerlendirilmesi

Yıl 2022, Cilt: 6 Sayı: 1, 7 - 14, 22.04.2022

Osman Büyükşen Süleyman Bayraktar Murat Elevli

https://doi.org/10.46332/aemj.883605

Öz

Amaç: Akut solunum yetmezliğinde solunum desteği yöntemlerinden biri, giderek kullanım sıklığı artan yüksek akımlı nazal kanül oksijen tedavisidir (YANKOT). Bu çalışmada, solunum yetmezliği nedeniyle çocuk yoğun bakım ünitesine yatırılan ve YANKOT uygulanan hastaların retrospektif olarak değerlendirilmesi amaçlandı.
Araçlar ve Yöntem: Çalışma retrospektif olarak, Ocak 2015- Aralık 2017 tarihleri arasında çocuk yoğun bakım ünitesinde yatan ve YANKOT uygulanmış 104 hasta alınarak yapıldı.
Bulgular: Çalışmaya katılan hastaların yaşlarının medyan değeri 5 ay olarak saptandı. En sık yatış endikasyonu %97.1 oranında alt hava yolu hastalığıydı ve hastaların %52.9’unda tip 1 solunum yetmezliği saptandı. Çocuk yoğun bakımdaki yatış süresi medyan değeri 7 gün iken, YANKOT uygulama süresi medyan değeri 48 saat olarak saptandı. YANKOT alırken entübe olan hastalarda (%28.8) kronik hastalık ve kronik akciğer hastalığı entübe olmayanlara göre belirgin olarak yüksekti (p=0.001, p=0.033, sırasıyla). Hastalarda komplikasyon olarak %8.7’sinde nazal bölgede cilt hasarı, %1.9’unda pnömotoraks geliştiği saptandı. Çocuk yoğun bakım ünitesine yatıp YANKOT alırken ölen hastalarda kronik hastalık ve konjenital kalp hastalığı oran-ları hayatta kalan hastalara göre belirgin olarak yüksekti (p=0.043, p=0.003, sırasıyla).
Sonuç: Son yıllarda çocuklarda solunum yetmezliği tedavisinde kullanılmaya başlanan YANKOT’un sonuçları genellikle yüz güldürücüdür. Bununla birlikte bu yeni yöntemde komplikasyonların gelişebilmesi nedeniyle uygulama süresince yakın izlem gerekmektedir. 

Anahtar Kelimeler

çocuk çocuk yoğun bakım ünitesi solunum yetersizliği oksijen tedavisi

Kaynakça

  • 1. Mayfield S, Jauncey-Cooke J, Hough JL, Schibler A, Gibbons K, Bogossian F. High-flow nasal cannula therapy for respiratory support in children. Cochrane Database Syst Rev. 2014;2014(3):CD009850.
  • 2. Söğütlü Y, Biçer S, Kurt G, ve ark. Alt solunum yolu hastalığı olan çocuklarda yüksek akımlı nazal kanül oksijenasyon tedavisinin yaşamsal bulgular üzerindeki sonuçları. J Pediatr Emerg Intensive Care Med. 2016;3(3):121-130.
  • 3. Wing R, James C, Maranda LS, Armsby CC. Use of high-flow nasal cannula support in the emergency department reduces the need for intubation in pediatric acute respiratory insufficiency. Pediatr Emerg Care. 2012;28(11):1117-1123.
  • 4. Lee JH, Rehder KJ, Williford L, Cheifetz IM, Turner DA. Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature. Intensive Care Med. 2013;39(2):247-257.
  • 5. Slain KN, Shein SL, Rotta AT. The use of high-flow nasal cannula in the pediatric emergency department. J Pediatr (Rio J). 2017;93(1):36-45.
  • 6. Mikalsen IB, Davis P, Øymar K. High flow nasal cannula in children: a literature review. Scand J Trauma Resusc Emerg Med. 2016;24(1):1-12.
  • 7. Kezer S, Eryavuz Ö, Okuyan H. E, Atakan S. K, Mutlu D, Demirkol D. solunum yetersizliğinde yüksek akımlı oksijen tedavisi. Pediatri. 2018;10(3):12-18.
  • 8. Friedman ML, Nitu ME. Acute respiratory failure in children. Pediatr Ann. 2018;47(7):268-273.
  • 9. Köksoy ÖT, Paksu MŞ, Yener N, Kaplan EM. Çocuk yoğun bakım ünitesinde invaziv olmayan mekanik ventilasyon uygulanan hastaların geriye dönük değerlendirilmesi. J Pediatr Emerg Intensive Care Med. 2016;3(2):62-68.
  • 10. Hasani A, Chapman TH, McCool D, Smith RE, Dilworth JP, Agnew JE. Domiciliary humidification improves lung mu-cociliary clearance in patients with bronchiectasis. Chron Respir Dis. 2008;5(2):81-86.
  • 11. Rea H, McAuley S, Jayaram L, et al. The clinical utility of long-term humidification therapy in chronic airway disease. Respir Med. 2010;104 (4):525-533.
  • 12. Dysart K, Miller TL, Wolfson MR, Shaffer TH. Research in high flow therapy: mechanisms of action. Respir Med. 2009;103(10):1400-1405.
  • 13. Masip J, Roque M, Sánchez B, Fernández R, Subirana M, Expósito JA. Noninvasive ventilation in acute cardiogenic pulmonary edema:systematic review and meta-analysis. JAMA. 2005;294(24):3124-3130.
  • 14. Milési C, Boubal M, Jacquot A, et al. High-flow nasal cannula: recommendations for daily practice in pediatrics. Ann Intensive Care. 2014;4(1):1-7.
  • 15. Oto A, Erdogan S, Bosnak M. Oxygen therapy via high flow nasal cannula in pediatric intensive care unit. Turk J Pedi-atr. 2016;58(4):377-382.
  • 16. Roca O, Riera J, Torres F, Masclans JR. High-flow oxygen therapy in acute respiratory failure. Respir Care. 2010;55(4):408-413.
  • 17. Testa G, Iodice F, Ricci Z, et al. Comparative evaluation of high-flow nasal cannula and conventional oxygen therapy in paediatric cardiac surgical patients: a randomized controlled trial. Interact Cardiovasc Thorac Surg. 2014;19(3):456-461.
  • 18. Çapan K, Apaydın HO, Geyik M. Yüksek akımlı nazal kanül oksijenasyon tedavisine bağlı pnömotoraks olgusu. J Pe-diatr Emerg Intensive Care Med. 2017;4(2):80-83.
  • 19. Schwabbauer N, Berg B, Blumenstock G, Haap M, Hetzel J, Riessen R. Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxy-gen therapy and non-invasive ventilation (NIV). BMC Anesthesiol. 2014;14(1):1-7.
  • 20. Yurtseven A, Saz EU. The effectiveness of heated humidified high-flow nasal cannula in children with severe bacterial pneumonia in the emergency department. J Pediatr Res. 2020;7(1):1-7.
  • 21. Baudin F, Buisson A, Vanel B, Massenavette B, Pouyau R, Javouhey E. Nasal high flow in management of children with status asthmaticus: a retrospective observational study. Ann Intensive Care. 2017;7(1):1-9.
  • 22. Hegde S, Prodhan P. Serious air leak syndrome complicating high-flow nasal cannula therapy: a report of 3 cases. Pedi-atrics. 2013;131(3):939-944.
  • 23. Fleeman N, Mahon J, Bates V, et al. The clinical effectiveness and cost-effectiveness of heated humidified highflow na-sal cannula compared with usual care for preterm infants: systematic review and economic evaluation. Health Technol Assess. 2016;20(30):1-68.
  • 24. Lin J, Zhang Y, Xiong L, Liu S, Gong C, Dai J. High-flow nasal cannula therapy for children with bronchiolitis: a sys-tematic review and meta-analysis. Arch Dis Child. 2019;104(6):564-576.
  • 25. Kawaguchi A, Yasui Y, deCaen A, Garros D. The clinical ımpact of heated humidified high-flow nasal cannula on pedi-atric respiratory distress. Pediatr Crit Care Med. 2017;18(2):112-119.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Bilimsel Araştırma Makaleleri
Yazarlar

Osman Büyükşen 0000-0002-4264-0095

Süleyman Bayraktar 0000-0002-8080-2438

Murat Elevli 0000-0002-0510-965X

Yayımlanma Tarihi 22 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 6 Sayı: 1

Kaynak Göster

APA Büyükşen, O., Bayraktar, S., & Elevli, M. (2022). Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit. Ahi Evran Medical Journal, 6(1), 7-14. https://doi.org/10.46332/aemj.883605
AMA Büyükşen O, Bayraktar S, Elevli M. Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit. Ahi Evran Med J. Nisan 2022;6(1):7-14. doi:10.46332/aemj.883605
Chicago Büyükşen, Osman, Süleyman Bayraktar, ve Murat Elevli. “Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit”. Ahi Evran Medical Journal 6, sy. 1 (Nisan 2022): 7-14. https://doi.org/10.46332/aemj.883605.
EndNote Büyükşen O, Bayraktar S, Elevli M (01 Nisan 2022) Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit. Ahi Evran Medical Journal 6 1 7–14.
IEEE O. Büyükşen, S. Bayraktar, ve M. Elevli, “Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit”, Ahi Evran Med J, c. 6, sy. 1, ss. 7–14, 2022, doi: 10.46332/aemj.883605.
ISNAD Büyükşen, Osman vd. “Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit”. Ahi Evran Medical Journal 6/1 (Nisan 2022), 7-14. https://doi.org/10.46332/aemj.883605.
JAMA Büyükşen O, Bayraktar S, Elevli M. Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit. Ahi Evran Med J. 2022;6:7–14.
MLA Büyükşen, Osman vd. “Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit”. Ahi Evran Medical Journal, c. 6, sy. 1, 2022, ss. 7-14, doi:10.46332/aemj.883605.
Vancouver Büyükşen O, Bayraktar S, Elevli M. Evaluation of Clinical and Epidemiological Features of Patients Receiving High-Flow Nasal Cannula Oxygen Therapy in the Pediatric Intensive Care Unit. Ahi Evran Med J. 2022;6(1):7-14.
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