![]() Failure of HFNC was defined as the need to scale up to NIV or MV. This article included patients with distress or acute respiratory failure from one month to 18 years admitted to the PICU and treated with HFNC as primary support or as support after extubation. ![]() 9 in 2017, also studies children hospitalized in Pediatric Intensive Care Unit (PICU), particularly to the usefulness of the relationship between oxygen saturation and F iO 2 (SpO 2/F iO 2), as an outcome predictor of HFNC therapy. Finally, the scores of Pediatric Risk of Mortality III (PRISM-III) in patients who failed, were significantly higher (p<0.001), in comparison to the group of patients who presented good response to the therapy. On the other hand, the Respiratory Rate (RR), at the beginning of the connection to HFNC, also correlates strongly with respiratory deterioration (p<0.001) and carbon dioxide blood pressure was significantly higher before (p<0.001) and after (p<0.001) the therapy in non-responder group. In this study the average weight and the weight corrected by age were significantly lower in the group of patients who required intubation (p=0.016 and p=0.031, respectively). 8 defines failure of HFNC as the intubation requirement. 5 Furthermore, it is a friendly system, which allows its use outside of critical units. At the same time HFNC has multiple advantages over other supports, for example: (1) it favours the gas mixture to be heated and humidified to reduce the risk of damage of the upper airway mucous, (2) the concentration of O 2 can be precisely titled, (3) it favours better tolerance and (4) helps to reduce work of breath and the need for greater ventilatory support. 3, 4Īlong with Non-Invasive Ventilation (NIV), HFNC seek to treat respiratory failure avoiding the need for invasive Mechanical Ventilation (MV), and preventing post-extubation failure. 2 Its main mechanisms of action are the increase of inspired fraction of oxygen (F iO 2) washing of the nasopharyngeal dead space, increase of the final expiratory volume and functional residual capacity, provision of correct humidification to the airway and decrease of inspiratory resistance. 1 It consists in the administration of gas flows, mixture of air and oxygen (O 2), which exceed the patient's ventilatory demands. High Flow Nasal Cannula (HFNC) is a non-invasive oxygen therapy system, initially used in the neonatal population and currently widely used in pediatric and adult patients. Keywords: high flow nasal cannula, nasal high flow, oxygen therapy, paediatrics, predictors, failure Abbreviations This situation makes the early characterization of patients who require HFNC more difficult, and therefore, the individualized decisions that could eventually improve economical and clinical outcomes of our pediatric patients. Regarding the identification of clinical parameters, some of the studies mentioned their correlation with failure, but during the administration of the therapy and not previously. On the other hand, although predictive factors of failure have been identified, in most studies, are restricted to demographic characteristics, comorbidities, severity indexes and/or require the taking of arterial blood tests, therefore their applicability outside of the Pediatric Intensive Care Unit (PICU), is limited. ![]() Objective: To collect and analyse the available literature in relation to the definition and clinical parameters that predict the failure of HFNC therapy, in hospitalized pediatric patients inside and outside the ICU, in order to provide knowledge to clinicians to optimize the management of this device, facilitate the administration of the resources and finally, improve the pediatric patients outcomes by identifying the clinical predictors of HFNC failure.Ĭonclusion: There is no consensus regarding the definition of failure of HFNC, which makes it difficult to interpretate the results of the studies and, therefore, its translation into clinical practice. ![]() High Flow Nasal Cannula (HFNC) is a non-invasive oxygen therapy system it consists in the administration of gas flows, mixture of air and oxygen (O2), which exceed the patient's ventilatory demands and also it is a friendly system, which allows its use outside of critical units. ![]()
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