Sokuri Paula, Heikkilä Paula, Korppi Matti
Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Acta Paediatr. 2017 Dec;106(12):1998-2003. doi: 10.1111/apa.13964. Epub 2017 Jul 14.
High-flow nasal cannula (HFNC) therapy provides noninvasive respiratory support for infant bronchiolitis and its use has increased following good clinical experiences. This national study describes HFNC use in Finland during a severe respiratory syncytial virus (RSV) epidemic.
A questionnaire on using HFNC for infant bronchiolitis during the 2015-2016 RSV epidemic was sent to the head physicians of 18 Finnish children's hospitals providing inpatient care for infants: 17 hospitals answered, covering 77.5% of the infants born in Finland in 2015.
Most (85%) HFNC was given on paediatric wards. The mean incidence for bronchiolitis treated with HFNC in infants under the age of one in 15 of 17 hospitals was 3.8 per 1000 per year (range: 1.4-8.1): one hospital did not supply the relevant data and one supplied a figure of 34.1 due to a different treatment policy. Instructions on how to start and wean HFNC therapy were present in 71% and 61% of the hospitals, respectively, weighted to the population. Providing weaning instructions was associated with shorter weaning times.
High-flow nasal cannula was actively used for infants with bronchiolitis, with no substantial overuse. Randomised controlled studies are needed before any evidence-based guidelines can be constructed for using HFNC in infant bronchiolitis.
高流量鼻导管（HFNC）疗法为婴儿细支气管炎提供无创呼吸支持，且在良好的临床经验后其使用有所增加。这项全国性研究描述了在严重呼吸道合胞病毒（RSV）流行期间芬兰HFNC的使用情况。
向为婴儿提供住院治疗的18家芬兰儿童医院的主任医师发送了一份关于在2015 - 2016年RSV流行期间使用HFNC治疗婴儿细支气管炎的调查问卷：17家医院回复，覆盖了2015年在芬兰出生婴儿的77.5%。
大多数（85%）HFNC治疗在儿科病房进行。17家医院中的15家，一岁以下婴儿中接受HFNC治疗的细支气管炎的年平均发病率为每1000人中有3.8例（范围：1.4 - 8.1）：一家医院未提供相关数据，另一家因不同的治疗政策提供了34.1这一数字。分别有71%和61%的医院（根据人口加权）有关于如何开始和撤机HFNC治疗的说明。提供撤机说明与较短的撤机时间相关。
高流量鼻导管被积极用于治疗细支气管炎婴儿，且无大量过度使用情况。在为婴儿细支气管炎使用HFNC制定任何循证指南之前，需要进行随机对照研究。
