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Extubation to High-Flow Nasal Cannula in Infants Following Cardiac Surgery: A Retrospective Cohort Study
| Content Provider | Scilit |
|---|---|
| Author | Stevens, Hannah Gallant, Julien Foster, Jennifer Horne, David Krmpotic, Kristina |
| Copyright Year | 2021 |
| Description | High-flow nasal cannula (HFNC) therapy is commonly used in the pediatric intensive care unit (PICU) for postextubation respiratory support. This hypothesis-generating retrospective cohort study aimed to compare postextubation PICU length of stay in infants extubated to HFNC and low flow oxygen (LF) in PICU following cardiac surgery. Of 136 infants (newborn to 1 year) who were intubated and mechanically ventilated in PICU following cardiac surgery, 72 (53%) were extubated to HFNC and 64 (47%) to LF. Compared with patients extubated to LF, those extubated to HFNC had significantly longer durations of cardiopulmonary bypass (152 vs. 109 minutes; p = 0.002), aortic cross-clamp (90 vs. 63 minutes; p = 0.003), and invasive mechanical ventilation (3.2 vs. 1.6 days; p < 0.001), though demographic and preoperative clinical variables were similar. No significant difference was observed in postextubation PICU length of stay between HFNC and LF groups in unadjusted analysis (3.3 vs. 2.6 days, respectively; p = 0.19) and after controlling for potential confounding variables (F [1,125] = 0.17, p = 0.68, $R^{2}$ = 0.16). Escalation of therapy was similar between HFNC and LF groups (8.3 vs. 14.1%; p = 0.41). HFNC was effective as rescue therapy for six patients in the LF group requiring escalation of therapy. Need for reintubation was similar between HFNC and LF groups (8.3 vs. 4.7%; p = 0.5). Although extubation to HFNC was associated with a trend toward longer postextubation PICU length of stay and was successfully used as rescue therapy for several infants extubated to LF, our results must be interpreted with caution given the limitations of our study. Received: 14 December 2020 Accepted: 21 April 2021 Publication Date: 19 June 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1730933.pdf |
| ISSN | 21464618 |
| DOI | 10.1055/s-0041-1730933 |
| Journal | Journal of Pediatric Intensive Care |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2021-06-19 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Pediatric Intensive Care Pediatrics and Child Health High-flow Nasal Cannula Mechanical Ventilation Noninvasive Ventilation Pediatric Cardiac Surgery Pediatric Intensive Care Unit |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health |
