High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study

Introduction: The present study describes our experience with the high -flow humidified nasal ventilation; cannula (HFNC) versus non-invasive ventilation (NIV) in children with severe acute asthma High-flow nasal exacerbation (SA). Methods: An observational study of a retrospective cohort of 42 children with SA admitted Asthma exacerbation; to a Pediatric Intensive Care Unit (PICU) for non-invasive respiratory support was made. The Critical care; primary outcome measure was failure of initial respiratory support (need to escalate from HFNC Children; to NIV or from NIV to invasive ventilation). Secondary outcome measures were the duration of Length of stay respiratory support and PICU length of stay (LOS). Results: Forty-two children met the inclusion criteria. Twenty (47.6%) received HFNC and 22 (52.3%) NIV as initial respiratory support. There were no treatment failures in the NIV group. However, 8 children (40%) in the HFNC group required escalation to NIV. The PICU LOS was similar in both the NW and HFNC groups. However, on considering the HFNC failure subgroup, the median length of respiratory support was 3-fold longer (63 h) and the PICU LOS was also longer compared with the rest of subjects exhibiting treatment success. Conclusions: Despite its obvious limitations, this observational study could suggest that HFNC in some subjects with SA may delay NW support and potentially cause longer respiratory support, and longer PICU LOS. (C) 2017 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.