Use of high flow nasal cannula in infants younger than 24 months in general pediatric rooms

Abstract

Background and aim: Bronquiolitis remains the most common respiratory etiology that affects
children under 2 years of age, and the most common cause of hospitalization in this age group.
Non-invasive technology with high flow nasal cannula was first introduced in Costa Rica in 2008;
the main goal of the study was to demonstrate the utility of this cannula in children under 2 years
of age with respiratory disease.
Methodology: Transversal observational study, in children under 2 years of age that required
high flow nasal cannula therapy, from July to October 2015 in Costa Rica's main hospital, Hospital
Nacional de Niños.
Results: a final simple of 63 patients was obtained. The majority came from the central area
of the country, with an average age of 10 months and an average weight of 8,6 kg. The main diagnosis was bronquiolitis. The most commonly virus found was the Metaneumovirus. There was a significant improve in the oxygen saturation with the device (p < 0,05) and a significant reduction in respiratory rates (p 0,016) between the children that did not required intubation of at least 30% from the initial value. Up to 95% of the patients with initial oxygen saturation less tan 87% required mechanical ventilation. The average duration of the therapy was of two days. 16 patients (25%) required mechanical ventilation.

Conclusions: In Costa Rica, the high flow nasal cannula therapy works and improves clinical parameters. The patients that required intubation were those in which the improvement of the severity scale was of 2 or less points, was no reduction in respiratory rates of at least 30% and the initial oxygen saturation was less than 87%.