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

Article


Schibler, A., Pham, T., Dunster, K.R., Foster, K., Barlow, A., 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. https://doi.org/10.1007/s00134-011-2177-5
Article Title

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

ERA Journal ID16232
Article CategoryArticle
AuthorsSchibler, A. (Author), Pham, T. (Author), Dunster, K.R. (Author), Foster, K. (Author), Barlow, A. (Author), Gibbons, K. (Author) and Hough, J.L. (Animator)
Journal TitleIntensive Care Medicine
Journal Citation37, pp. 847-852
Number of Pages6
Year2011
Place of PublicationGermany
ISSN0342-4642
1432-1238
Digital Object Identifier (DOI)https://doi.org/10.1007/s00134-011-2177-5
Web Address (URL)https://link.springer.com/article/10.1007/s00134-011-2177-5
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.

KeywordsHigh-flow nasal cannula; Oxygen delivery; Infant
ANZSRC Field of Research 2020420501. Acute care
Institution of OriginUniversity of Southern Queensland
ISBN03424642 14321238
Byline AffiliationsMater Group, Australia
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