Comparison of high flow oxygen therapy versus noninvasive mechanical ventilation for successful weaning from invasive ventilation in children: An observational study.

Content Provider	Europe PMC
Author	Celik, Nur Berna Tanyildiz, Murat Yetimakman, Filiz Kesici, Selman Bayrakci, Benan
Copyright Year	2022
Abstract	Post-extubation respiratory failure is associated with a poor prognosis due to increased ventilator-associated pneumonia, and longer length of stay in the ICU and hospital. In this study, we aimed to evaluate the efficacy of high-flow nasal cannula (HFNC) and noninvasive mechanical ventilation (NIMV) on extubation success in children. A total of 48 patients, aged between 1 month and 18 years, who were weaned to either NIMV or HFNC were included. Patients who had tracheostomy or were not weaned and underwent unplanned extubation were excluded. Age, gender, anthropometric parameters, Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction scores, oxygenation index, mechanical ventilation length of stay (LOS), HFNC/NIMV LOS, Modified Downes-Silverman score (MDS), and venous blood gas parameters, pediatric intensive care unit (PICU) LOS were recorded. 24 patients were extubated to NIMV, and 24 patients to HFNC. HFNC LOS and NIMV LOS were similar (P = .621). The failure rates at the 48th hour of HFNC and NIMV were 33% (n = 8), and 33% respectively (n = 8) (P = 1.0). PICU LOS and mortality rate was also similar (P = .06, P = .312 respectively). MDS decreased significantly in both groups (P < .001, P = .02 respectively). Changes in blood gas parameters and MDS within the first 48-hour of device application were similar between the 2 groups. HFNC is not inferior to NIMV in patients with extubation difficulty or those expected to have such difficulty in terms of treatment success, PICU LOS, and mortality. Therefore, HFNC appears to be a weaning technique alternative to NIMV after extubation.
ISSN	00257974
Journal	Medicine
Volume Number	101
PubMed Central reference number	PMC9524993
Issue Number	39
PubMed reference number	36181066
e-ISSN	15365964
DOI	10.1097/md.0000000000030889
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2022-09-01
Publisher Place	Hagerstown, MD
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
Subject Keyword	critical care high-flow nasal cannula non-invasive ventilation pediatric weaning
Content Type	Text
Resource Type	Article
Subject	Medicine