Risk factors for treatment failure of High flow nasal cannula as an initial respiratory support in neonates with respiratory distress
Keywords:
High flow nasal cannula, respiratory distress in neonatesAbstract
Background: High flow nasal cannula (HFNC) is a popular non-invasive breathing device today. But there are no data on the efficacy and safety of using HFNC in neonates with respiratory distress.
Purpose: To investigate risk factors for treatment failure of HFNC as an initial respiratory support in newborns with respiratory distress after birth. Compare outcomes and complications of neonates both groups.
Method: Retrospective case-control study in neonates admitted from October 1, 2016 to February 28, 2021 with respiratory distress at receiving initial treatment with HFNC, statistical data were analyzed for risk factors, and data were compared for the failure group
with the success group.
Results: A total of 217 neonates had 29.5% HFNC failure rate. Compared with the success group, the failure group had higher higher incidence of maternal meconium-stained amniotic fluid (MSAF), MAS and PPHN significant. In the failure group, there were more hypoxia problems and therefore lower blood oxygen saturation, and the HFNC setting FiO2 was greater than in the success group. WBC count was lower but the mean CRP age 6-23 hours and CRP age 24-48 hours were greater than the success group. MAS and PPHN is significant risk factor of failure group. Failure group had air leak syndrome and need to be referred for further treatment,the number of days the ventilator, oxygen used, and hospitalization days were significantly higher than those in the success group.
Conclusion: Treatment failure of HFNC should be considered a risk for neonates with respiratory distress from MAS, PPHN. Neonates with severe hypoxia and with higher HFNC FiO2 settings may help for other noninvasive ventilators or intubation.
Downloads
References
Warren JB, Anderson JM. Newborn respiratory disorder. Pediatr Rev.2010;31:487-95.
Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. PaediatrRespir Rev.2013; 14:29-36.
Kumar A, Bhat B. Epidemiology of respiratory distress of newborns, Indian Journal of Pediatrics 1996; 63:93-8.
วราภรณ์แสงทวีสิน,วิบูลย์กาญจนพัฒนกุล,สุนทรฮ้อเผ่าพันธ์และคณะ. Respiratory Distress andRespiratoryDistressSyndrome.ปัญหาทารกแรกเกิด. กรุงเทพ:ธนาเพลส,2550; 97-109.
Hillman N, Jobe AH. Noninvasive strategies for management of respiratory problems in neonates, Neoreviews 2013; 14(5):e227-36.
Dani C, Pratesi S, Migliori C, et al. High flow nasal cannula therapy as respiratory support in the preterm infant. Pediatr Pulmonol
;44:629e34.
Osman M, Elsharkawy A, Abdel-Hady H. Assessment of pain during application of nasal-continuous positive airway pressure and heated, humidified high-flow nasal cannulae in preterm infants. J Perinatol 2015;35:263e7.
Klingenberg C, Pettersen M, Hansen EA, et al. Patient comfort during treatment with heated humidified high flow nasal cannulae versus nasal continuous positive airway pressure: a randomized cross-over trial. Arch Dis Child Fetal Neonatal Ed 2014;99: F134e7.
Mardegan V, Priante E, Lolli E, et al. Heated, humidified high-flow nasal cannulae as a form of noninvasive respiratory support for preterm infants and children with acute respiratory failure. Am J Perinatol 2016;33:1058e61.
Manley BJ, Owen LS. High-flow nasal cannula: mechanisms, evidence and recommendations. Semin Fetal Neonatal
Med 2016;21:139e45.
Chao KY, Chen YL, Tsai LY, et al. The role of heated humidified high-flow nasal cannula as noninvasive respiratory support in neonates.
Pediatr Neonatol 2017;58:295e302.
Fleeman N, Mahon J, Bates V, et al. The clinical effectiveness and costeffectiveness of heated humidified high-flow nasal cannula compared with usual care for preterm infants: systematic review and economic evaluation. Health Technol Assess 2016;20:1e68.
กุสุมา สยะนานนท์, อารียา ดีสมโชค. เปรียบเทียบการใช้Heated Humidified High flow NasalCannula (HHHFNC) และ Nasal Continuous
Positive Airway Pressure (NCPAP) หลังถอดท่อช่วยหายใจในทารกแรกเกิดก่อนกำ หนด: พุทธชินราชวารสาร2016;33:156-67.
ศศิวิมล สุ่นสวัสดิ์. การศึกษาการใช้High-flowNasal Cannula เปรียบเทียบกับการใช้NasalContinuous Positive Airway Pressure (NCPAP)ในการป้องกันการใส่ท่อช่วยหายใจกลับซ้ำและเพื่อช่วยถอนการใช้continuous positive airwaypressure(NCPAP).www.thaipediatrics.org.2558.
Holleman-Duray D, Kaupie D, Weiss MG. Heated humidified high-flow nasal cannula:use and a neonatal early extubation protocol. J Perinatol 2007;27:776-81.16. Shoemaker MT, Pierce MR, Yoder BA, et al. High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study. J Perinatol 2007;27:85-91.
Collins C. High flow nasal cannulae cause less nasal trauma compared to nasal continuous positive airway pressure in preterm infants.
Arch Dis Child 2012; 97: A116-7.
Won Young Lee, Eui Kyung Choi, Jeonghee Shin, et al. Risk factors for treatment failure of heated humidified high-flow nasal cannula
as an initial respiratory support in newborn infants with respiratory distress. Pedatrics and Neonatology 2020; 61:174-179.
Shoemaker MT, Pierce MR, Yoder BA, et al. High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective
study. J Perinatol 2007;27:85e91.
Kugelman A, Riskin A, Said W, et al. Bader D. A randomized pilot study comparing heated humidified high-flow nasal cannulae with NIPPV for RDS. Pediatr Pulmonol 2015;50:576e83.
Murki S, Singh J, Khant C, et al. Highflow nasal cannula versus nasal continuous positive airway pressure for primary respiratory support in preterm infants with respiratory distress: a randomized controlled trial.Neonatology 2018;113:235e41.
Zheng G, Huang XQ, Zhao HH, et al. The effect of the treatment with heated humidified high-flow nasal cannula on neonatal respiratory distress syndrome in China: a single center experience. Can Respir J 2017;2017:3782401.
Ciuffini F, Pietrasanta C, Lavizzari A, et al. Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data. Pediatr Med Chir 2014;36:153e8.
Shin J, Park K, Lee EH, Choi BM. Humidified high flow nasal cannula versus nasal continuous positive airway pressure as an initial respiratory support in preterm infants with respiratory distress: a randomized, controlled non-inferiority trial. J Korean Med Sci 2017;32:650e5.
อนันต์โฆษิตเศรษฐ, เปรมฤดีภูมิถาวร,อัญชลีลิ้มรังสิกุลและคณะ.Sepsis. Ramathibodi Handbook of PICU and NICU.2561;177-179.
Roehr CC, Yoder BA, Davus OG, et al. Evidence support and guidelines for using heated, humidified, high-flow therapy meeting, 2015. Clin Perinatol 2016;43:693-705.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
