Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress
Background Heated humidified high-flow nasal cannula (HFNC) has gained popularity recently and is considered a standard respiratory support tool for pediatric patients with acute respiratory distress. However, data are limited on the bedside parameters that can predict HFNC failure in pediatric pati...
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| Format: | Article |
| Language: | English |
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The Korean Pediatric Society
2022-12-01
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| Series: | Clinical and Experimental Pediatrics |
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| Online Access: | http://www.e-cep.org/upload/pdf/cep-2022-00241.pdf |
| _version_ | 1797987620558471168 |
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| author | Kantara Saelim Busawan Thirapaleka Kanokpan Ruangnapa Pharsai Prasertsan Wanaporn Anuntaseree |
| author_facet | Kantara Saelim Busawan Thirapaleka Kanokpan Ruangnapa Pharsai Prasertsan Wanaporn Anuntaseree |
| author_sort | Kantara Saelim |
| collection | DOAJ |
| description | Background Heated humidified high-flow nasal cannula (HFNC) has gained popularity recently and is considered a standard respiratory support tool for pediatric patients with acute respiratory distress. However, data are limited on the bedside parameters that can predict HFNC failure in pediatric patients. Purpose To evaluate the performance of SpO2/FiO2 (SF) ratio, pediatric respiratory rate-oxygenation (pROX) index, and clinical respiratory score (CRS), for predicting the HFNC outcomes. Methods This prospective observational study included 1- month to 15-year-old patients with acute respiratory distress who required HFNC support. The HFNC setting, vital signs, CRS, and treatment outcomes were recorded. Data were analyzed to determine the predictors of HFNC failure. Results Eighty-two children participated in the study, 16 of whom (19.5%) did not respond to HFNC treatment (failure group). Pneumonia was the main reason for intubation (62.5%). Predictors of HFNC failure at 12 hours were: SF index ≤166 (sensitivity, 62.5%; specificity, 87.8%; area under the curve [AUC], 0.75), pROX index <132 (sensitivity, 68.7%; specificity, 84.8%; AUC, 0.77), and CRS ≥6 (sensitivity, 87.5%; specificity, 96.9%; AUC, 0.92). Conclusion The CRS was the most accurate predictor of HFNC failure in pediatric patients. A CRS ≥ 6 at 12 hours after HFNC initiation and pROX, a newly modified parameter, are helpful indicators of HFNC failure. |
| first_indexed | 2024-04-11T07:51:05Z |
| format | Article |
| id | doaj.art-f277f0c73c9d4caf96b163769ede94d2 |
| institution | Directory Open Access Journal |
| issn | 2713-4148 |
| language | English |
| last_indexed | 2024-04-11T07:51:05Z |
| publishDate | 2022-12-01 |
| publisher | The Korean Pediatric Society |
| record_format | Article |
| series | Clinical and Experimental Pediatrics |
| spelling | doaj.art-f277f0c73c9d4caf96b163769ede94d22022-12-22T04:36:06ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482022-12-01651259560110.3345/cep.2022.0024120125555565Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distressKantara Saelim0Busawan Thirapaleka1Kanokpan Ruangnapa2Pharsai Prasertsan3Wanaporn Anuntaseree4Division of Pulmonology and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, ThailandDivision of Pulmonology and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, ThailandDivision of Pulmonology and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, ThailandDivision of Pulmonology and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, ThailandDivision of Pulmonology and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, ThailandBackground Heated humidified high-flow nasal cannula (HFNC) has gained popularity recently and is considered a standard respiratory support tool for pediatric patients with acute respiratory distress. However, data are limited on the bedside parameters that can predict HFNC failure in pediatric patients. Purpose To evaluate the performance of SpO2/FiO2 (SF) ratio, pediatric respiratory rate-oxygenation (pROX) index, and clinical respiratory score (CRS), for predicting the HFNC outcomes. Methods This prospective observational study included 1- month to 15-year-old patients with acute respiratory distress who required HFNC support. The HFNC setting, vital signs, CRS, and treatment outcomes were recorded. Data were analyzed to determine the predictors of HFNC failure. Results Eighty-two children participated in the study, 16 of whom (19.5%) did not respond to HFNC treatment (failure group). Pneumonia was the main reason for intubation (62.5%). Predictors of HFNC failure at 12 hours were: SF index ≤166 (sensitivity, 62.5%; specificity, 87.8%; area under the curve [AUC], 0.75), pROX index <132 (sensitivity, 68.7%; specificity, 84.8%; AUC, 0.77), and CRS ≥6 (sensitivity, 87.5%; specificity, 96.9%; AUC, 0.92). Conclusion The CRS was the most accurate predictor of HFNC failure in pediatric patients. A CRS ≥ 6 at 12 hours after HFNC initiation and pROX, a newly modified parameter, are helpful indicators of HFNC failure.http://www.e-cep.org/upload/pdf/cep-2022-00241.pdfhigh-flow nasal cannulapredictorsacute respiratory distresschild |
| spellingShingle | Kantara Saelim Busawan Thirapaleka Kanokpan Ruangnapa Pharsai Prasertsan Wanaporn Anuntaseree Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress Clinical and Experimental Pediatrics high-flow nasal cannula predictors acute respiratory distress child |
| title | Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress |
| title_full | Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress |
| title_fullStr | Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress |
| title_full_unstemmed | Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress |
| title_short | Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress |
| title_sort | predictors of high flow nasal cannula failure in pediatric patients with acute respiratory distress |
| topic | high-flow nasal cannula predictors acute respiratory distress child |
| url | http://www.e-cep.org/upload/pdf/cep-2022-00241.pdf |
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