Children's National Hospital, Washington, District of Columbia
Children's National Hospital, Washington, District of Columbia.
Pediatrics. 2020 Nov;146(5). doi: 10.1542/peds.2019-4083. Epub 2020 Oct 8.
To describe the practice of high-flow nasal cannula (HFNC) use in the pediatric ward setting across North America.
A survey was distributed through the Pediatric Research in Inpatient Settings Network, which represents 114 hospital sites. Questions included indication for HFNC use, flow and oxygen parameters, guideline availability, and use of outcomes measures.
There was a response rate of 68% to the survey from sites representing all regions from the United States. Thirty-seven sites (48%) used HFNC in the pediatric ward setting. All 37 sites used HFNC for patients with bronchiolitis. All children's hospital sites providing HFNC on the wards had an on-site ICU, compared with only 60% of non-children's hospital sites ( = .003). Seventy-six percent of sites used local protocols, including parameters for patient assessment, initiation, weaning, and feeding practices.
HFNC is used outside the ICU in nearly 50% of responding hospitals, with variation related to flow rate, feeding, and protocol use. HFNC is used for management of acute respiratory distress due to bronchiolitis, asthma, and pneumonia. Study findings suggest that HFNC is often used by pediatric hospitalists, but its use across North American hospitals remains variable and based on local consensus.
描述北美儿科病房环境中高流量鼻导管（HFNC）使用的实践情况。
通过儿科住院患者研究网络（代表 114 个医院地点）分发了一份调查问卷。问题包括 HFNC 使用的适应证、流量和氧参数、指南的可用性以及使用结局指标的情况。
对该调查的回复率为 68%，来自美国所有地区的医院地点。37 个地点（48%）在儿科病房环境中使用 HFNC。所有 37 个地点均将 HFNC 用于毛细支气管炎患者。所有提供病房内 HFNC 的儿童医院都设有院内 ICU，而非儿童医院仅为 60%（ =.003）。76%的地点使用了当地的方案，包括患者评估、启动、撤机和喂养实践的参数。
近 50%的参与调查的医院在 ICU 之外使用 HFNC，其使用情况因流量、喂养和方案使用的差异而有所不同。HFNC 用于毛细支气管炎、哮喘和肺炎引起的急性呼吸窘迫的治疗。研究结果表明，HFNC 通常由儿科医院医生使用，但在整个北美医院的使用情况仍存在差异，且基于当地共识。
