Itdhiamornkulchai Sarocha, Preutthipan Aroonwan, Vaewpanich Jarin, Anantasit Nattachai
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clin Exp Pediatr. 2022 Mar;65(3):136-141. doi: 10.3345/cep.2020.01403. Epub 2021 May 24.
High-flow nasal cannula (HFNC) is a noninvasive respiratory support that provides the optimum flow of an air-oxygen mixture. Several studies demonstrated its usefulness and good safety profile for treating pediatric respiratory distress patients. However, the cost of the commercial HFNC is high; therefore, the modified high-flow nasal cannula was developed.
This study aimed to compare the effectiveness, safety, and nurses' satisfaction of the modified system versus the standard commercial HFNC.
This prospective comparative study was performed in a tertiary care hospital. We recruited children aged 1 month to 5 years who developed acute respiratory distress and were admitted to the pediatric intensive care unit. Patients were assigned to 2 groups (modified vs. commercial). The effectiveness and safety assessments included vital signs, respiratory scores, intubation rate, adverse events, and nurses' satisfaction.
A total of 74 patients were treated with HFNC. Thirty- nine patients were assigned to the modified group, while the remaining 35 patients were in the commercial group. Intubation rate and adverse events did not differ significantly between the 2 groups. However, the commercial group had higher nurses' satisfaction scores than the modified group.
Our findings suggest that our low-cost modified HFNC could be a useful respiratory support option for younger children with acute respiratory distress, especially in hospital settings with financial constraints.
高流量鼻导管（HFNC）是一种无创呼吸支持设备，可提供最佳的空气-氧气混合气流。多项研究表明其在治疗小儿呼吸窘迫患者方面的有效性和良好的安全性。然而，商用HFNC成本高昂；因此，开发了改良型高流量鼻导管。
本研究旨在比较改良系统与标准商用HFNC在有效性、安全性及护士满意度方面的差异。
本前瞻性对照研究在一家三级医疗机构进行。我们招募了1个月至5岁出现急性呼吸窘迫并入住儿科重症监护病房的儿童。患者被分为两组（改良组与商用组）。有效性和安全性评估包括生命体征、呼吸评分、插管率、不良事件及护士满意度。
共有74例患者接受了HFNC治疗。39例患者被分配至改良组，其余35例患者在商用组。两组的插管率和不良事件无显著差异。然而，商用组的护士满意度得分高于改良组。
我们的研究结果表明，对于患有急性呼吸窘迫的年幼儿童，尤其是在经济受限的医院环境中，我们低成本的改良型HFNC可能是一种有用的呼吸支持选择。
