Beckeringh Nike, Linssen Rosalie S N, Kapitein Berber, van Woensel Job B M, Plötz Frans B
Department of Paediatrics, Tergooi MC, Hilversum, The Netherlands.
Department of Paediatrics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands.
Acta Paediatr. 2025 Jun;114(6):1291-1297. doi: 10.1111/apa.17566. Epub 2024 Dec 30.
High flow nasal cannula (HFNC) therapy is a form of respiratory support used in children with bronchiolitis. A national guideline for the use of HFNC was published in The Netherlands in 2020. We studied the implementation and use of this guideline.
We performed a multicentre observational study amongst all hospitals in the North-West part of The Netherlands referring to the same paediatric intensive care unit (PICU). This study consisted of two parts: a comparison of local HFNC protocols to the national guideline and a survey about the use of HFNC amongst paediatricians in the participating centres.
We observed considerable variations between the local protocols and the national protocol, especially regarding criteria to initiate HFNC treatment and weaning practices. Survey results showed that expectations of HFNC widely varied, while the clinical use of HFNC deviated from both the national guideline as well as local protocols, especially for weaning practices and the use of pCO as a parameter for initiation and evaluation of the effect of HFNC.
Implementation of the national guideline for HFNC therapy in bronchiolitis was inefficacious, leading to non-uniform clinical practice.
高流量鼻导管（HFNC）治疗是用于治疗小儿细支气管炎的一种呼吸支持形式。2020年荷兰发布了关于使用HFNC的国家指南。我们研究了该指南的实施与应用情况。
我们在荷兰西北部所有转诊至同一儿科重症监护病房（PICU）的医院中开展了一项多中心观察性研究。本研究包括两个部分：将当地的HFNC方案与国家指南进行比较，以及对参与中心的儿科医生使用HFNC的情况进行调查。
我们观察到当地方案与国家方案之间存在相当大的差异，尤其是在启动HFNC治疗的标准和撤机方法方面。调查结果显示，对HFNC的期望差异很大，而HFNC的临床应用既不符合国家指南，也不符合当地方案，特别是在撤机方法以及将pCO作为启动HFNC和评估其效果的参数方面。
在小儿细支气管炎中实施HFNC治疗的国家指南效果不佳，导致临床实践不一致。
