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High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia

Background: The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. Methods: Using a prospective randomized co...

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Autores principales: Liu, Cong, Cheng, Wei Yu, Li, Jun Shao, Tang, Tian, Tan, Ping Li, Yang, Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693448/
https://www.ncbi.nlm.nih.gov/pubmed/33304868
http://dx.doi.org/10.3389/fped.2020.590906
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author Liu, Cong
Cheng, Wei Yu
Li, Jun Shao
Tang, Tian
Tan, Ping Li
Yang, Lin
author_facet Liu, Cong
Cheng, Wei Yu
Li, Jun Shao
Tang, Tian
Tan, Ping Li
Yang, Lin
author_sort Liu, Cong
collection PubMed
description Background: The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. Methods: Using a prospective randomized controlled study method, 84 patients with pneumonia and mild to moderate respiratory failure admitted to the Children's Hospital Affiliated to Chongqing Medical University from January 2018 to December 2019 were randomly divided into the HFNC group and the CPAP group. It was registered as a clinical trial at clinical trials.gov, registration number: ChiCTR2000030463. Results: The analyses included 84 patients. No differences were observed between the two groups in baseline demographic or physiological characteristics. Treatment failure necessitating intubation and transfer to the PICU was noted in six of 43 infants (14%) in the HFNC group, as compared with four of 41 infants (10%) in the CPAP group (P > 0.05). There were no significant differences between the two groups in the duration of hospital stay, the duration of non-invasive respiratory support, and mortality. The 10 infants who experienced treatment failure had more severe hypoxemia with lower PaO2/FiO2 (HFNC 182 ± 11.5 and CPAP 172 ± 8.6). We found that both the HFNC group and the CPAP group showed significantly improved oxygenation and relief of respiratory distress after treatment. No differences were observed between the two groups in the development improvement of RR, PaO2, PaCO2, SpO2, and PH. Assessment of the occurrence of adverse events showed that the HFNC group had a lower level of nasal injury, a lower risk of abdominal distension, a lower intensity and frequency of sedation, and better tolerance. Conclusion: HFNC is an effective and safe initial respiratory support treatment in children <2 years with mild to moderate respiratory failure due to pneumonia, and the incidence of intubation and death is very low; concurrently, the comfort and tolerance of HFNC are better. To some extent, HFNC is a well-tolerated alternative to CPAP.
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spelling pubmed-76934482020-12-09 High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia Liu, Cong Cheng, Wei Yu Li, Jun Shao Tang, Tian Tan, Ping Li Yang, Lin Front Pediatr Pediatrics Background: The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. Methods: Using a prospective randomized controlled study method, 84 patients with pneumonia and mild to moderate respiratory failure admitted to the Children's Hospital Affiliated to Chongqing Medical University from January 2018 to December 2019 were randomly divided into the HFNC group and the CPAP group. It was registered as a clinical trial at clinical trials.gov, registration number: ChiCTR2000030463. Results: The analyses included 84 patients. No differences were observed between the two groups in baseline demographic or physiological characteristics. Treatment failure necessitating intubation and transfer to the PICU was noted in six of 43 infants (14%) in the HFNC group, as compared with four of 41 infants (10%) in the CPAP group (P > 0.05). There were no significant differences between the two groups in the duration of hospital stay, the duration of non-invasive respiratory support, and mortality. The 10 infants who experienced treatment failure had more severe hypoxemia with lower PaO2/FiO2 (HFNC 182 ± 11.5 and CPAP 172 ± 8.6). We found that both the HFNC group and the CPAP group showed significantly improved oxygenation and relief of respiratory distress after treatment. No differences were observed between the two groups in the development improvement of RR, PaO2, PaCO2, SpO2, and PH. Assessment of the occurrence of adverse events showed that the HFNC group had a lower level of nasal injury, a lower risk of abdominal distension, a lower intensity and frequency of sedation, and better tolerance. Conclusion: HFNC is an effective and safe initial respiratory support treatment in children <2 years with mild to moderate respiratory failure due to pneumonia, and the incidence of intubation and death is very low; concurrently, the comfort and tolerance of HFNC are better. To some extent, HFNC is a well-tolerated alternative to CPAP. Frontiers Media S.A. 2020-11-13 /pmc/articles/PMC7693448/ /pubmed/33304868 http://dx.doi.org/10.3389/fped.2020.590906 Text en Copyright © 2020 Liu, Cheng, Li, Tang, Tan and Yang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Liu, Cong
Cheng, Wei Yu
Li, Jun Shao
Tang, Tian
Tan, Ping Li
Yang, Lin
High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title_full High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title_fullStr High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title_full_unstemmed High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title_short High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia
title_sort high-flow nasal cannula vs. continuous positive airway pressure therapy for the treatment of children <2 years with mild to moderate respiratory failure due to pneumonia
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693448/
https://www.ncbi.nlm.nih.gov/pubmed/33304868
http://dx.doi.org/10.3389/fped.2020.590906
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