Abstract
This study was aimed to evaluate the success rate of high-flow nasal cannula (HFNC)
oxygen therapy and factors causing therapy failure. This prospective observational
study included 131 children who received HFNC oxygen and followed-up in the pediatric
emergency department, pediatric clinics, and pediatric intensive care unit between
March 2018 and December 2019. The median age was 23.0 months (interquartile range
[IQR]: 9.0–92.0) and 65 patients were male (49.6%). The most common reason for requiring
HFNC oxygen therapy was pneumonia (n = 75, 57.3%). A complex chronic condition was present in 112 (85.5%) patients. Therapy
success was achieved in 116 patients (88.5%). The reason for requiring treatment and
the patients' complex chronic condition did not affect the success of the therapy
(p = 0.294 and 0.091, respectively). In the first 24 hours of treatment, a significant
improvement in pulse rate, respiratory rate, pH, and lactate level were observed in
successful HFNC oxygen patients (p < 0.05). In addition, these patients showed a significant improvement in SpO2 and SpO2/FiO2 ratio, and a significant decrease in FiO2 and flow rate (p < 0.05). HFNC oxygen success rate was 95.6% in patients with SpO2/FiO2 ≥ 150 at the 24th hour; it was 58.0% in those with SpO2/FiO2 < 150 (p < 0.001). Caution should be exercised in terms of HFNC oxygen failure in patients
with no significant improvement in vital signs and with SpO2/FiO2 < 150 during treatment.
Keywords
children - high-flow nasal cannula oxygen - outcome - respiratory distress
