Koçoğlu Barlas Ülkem, Özel Abdulrahman, Tosun Volkan, Ufuk Bozkurt Emine, Serdar Kıhtır Hasan
Department of Pediatrics, Pediatric Intensive Care Unit, Göztepe Prof Dr Süleyman Yalçın City Hospital, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey.
Department of Pediatrics, Bağcılar Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.
Turk Arch Pediatr. 2024 Mar;59(2):214-220. doi: 10.5152/TurkArchPediatr.2024.23301.
This study aimed to compare high-flow nasal cannula oxygen therapy (nc-HFOT) and non-invasive nasal cannula ventilation (nc-NIV) in terms of intubation requirements.
The study was conducted retrospectively on cases followed up in the pediatric intensive care unit (PICU) between October 2019 and December 2021.
Of all cases, 43 (55.8%) were male, and the median age was 16 months. The median PRISM-3 score for all cases was 2.5 (range: 0-3). Among the cases 45 cases (58.4%) received nc-HFOT treatment, and 32 cases (41.6%) received nc-NIV treatment. The median duration of respiratory support for all cases was 2 days, and 14 cases (18.2%) needed intubation. The median PICU stay day for all cases was 7 days, and the median hospital stay day was 11 days. The median age, PICU, and hospital stay days of the nc-NIV group were significantly higher (P < .05). In the logistic regression analysis, the probability of requiring intubation in cases initially nc-NIV was performed was found to be 4.95 times higher than those using nc-HFOT (OR: 4.95, 95% CI: 1.3-18.8, P = 0.01). Additionally, cases with underlying chronic diseases were found to have a 5.9 times increased likelihood of requiring intubation compared to those without (OR: 5.9, 95% CI: 1.41-24.5, P = .01). Five cases (6.5%) were lost during intensive care stay.
The application of nc-NIV increases intubation by 4.95 times compared to the application of nc-HFOT. The intubation rate in cases with underlying chronic diseases is also 5.9 times higher than those without.
本研究旨在比较高流量鼻导管给氧疗法（nc-HFOT）和无创鼻导管通气（nc-NIV）在插管需求方面的差异。
本研究对2019年10月至2021年12月在儿科重症监护病房（PICU）随访的病例进行回顾性分析。
所有病例中，43例（55.8%）为男性，中位年龄为16个月。所有病例的PRISM-3评分中位数为2.5（范围：0-3）。其中45例（58.4%）接受nc-HFOT治疗，32例（41.6%）接受nc-NIV治疗。所有病例的呼吸支持中位持续时间为2天，14例（18.2%）需要插管。所有病例的PICU住院天数中位数为7天，住院天数中位数为11天。nc-NIV组的中位年龄、PICU住院天数和住院天数显著更高（P<0.05）。在逻辑回归分析中，发现最初接受nc-NIV治疗的病例需要插管的概率比使用nc-HFOT的病例高4.95倍（OR：4.95，95%CI：1.3-18.8，P=0.01）。此外，发现有基础慢性疾病的病例需要插管的可能性比无基础慢性疾病的病例高5.9倍（OR：5.9，95%CI：1.41-24.5，P=0.01）。5例（6.5%）在重症监护期间失访。
与nc-HFOT相比，nc-NIV的应用使插管率增加4.95倍。有基础慢性疾病的病例插管率也比无基础慢性疾病的病例高5.9倍。
