Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery

Schibler, A. and Pham, T. M. T. and Dunster, K. R. and Foster, K. ORCID: https://orcid.org/0000-0002-3328-2177 and Barlow, A. and Gibbons, K. and Hough, J. L. (2011) Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Medicine, 37. pp. 847-852. ISSN 0342-4642


Abstract

Purpose
To describe the change in ventilatory practice in a tertiary paediatric intensive care unit (PICU) in the 5-year period after the introduction of high-flow nasal prong (HFNP) therapy in infants <24 months of age. Additionally, to identify the patient subgroups on HFNP requiring escalation of therapy to either other non-invasive or invasive ventilation, and to identify any adverse events associated with HFNP therapy.

Methods
The study was a retrospective chart review of infants <24 months of age admitted to our PICU for HFNP therapy. Data was also extracted from both the local database and the Australian New Zealand paediatric intensive care (ANZPIC) registry for all infants admitted with bronchiolitis.

Results
Between January 2005 and December 2009, a total of 298 infants <24 months of age received HFNP therapy. Overall, 36 infants (12%) required escalation to invasive ventilation. In the subgroup with a primary diagnosis of viral bronchiolitis (n = 167, 56%), only 6 (4%) required escalation to invasive ventilation. The rate of intubation in infants with viral bronchiolitis reduced from 37% to 7% over the observation period corresponding with an increase in the use of HFNP therapy. No adverse events were identified with the use of HFNP therapy.

Conclusion
HFNP therapy has dramatically changed ventilatory practice in infants <24 months of age in our institution, and appears to reduce the need for intubation in infants with viral bronchiolitis.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 10 Dec 2020 05:38
Last Modified: 10 Dec 2020 05:38
Uncontrolled Keywords: High-flow nasal cannula; Oxygen delivery; Infant
Fields of Research (2008): 11 Medical and Health Sciences > 1114 Paediatrics and Reproductive Medicine > 111403 Paediatrics
Fields of Research (2020): 42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care
Socio-Economic Objectives (2020): 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions
Identification Number or DOI: https://doi.org/10.1007/s00134-011-2177-5
URI: http://eprints.usq.edu.au/id/eprint/40327

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