Oxigenoterapia de alto flujo en lactantes internados en el Hospital Pediátrico del Niño Jesús de la ciudad de Córdoba, Argentina

Abstract

Oxygen is the main treatment in acute respiratory failure. High-flow oxygen therapy via nasal cannula (HFNC) is an alternative that provides a humidified oxygen flow, at body temperature, titrating FiO2 and generating rates of up to 60 L/min. Its application represents a benefit for patients and for health systems since it constitutes a simple technique that allows mobility, speaking and eating, with infrequent adverse effects and can be implemented in the hospital common room, improving respiratory pattern and clinical outcome. The stated objectives were: to describe the clinical results of HFNC therapy in our Hospital, in the period 2016 – 2019; to record admission diagnoses, isolated etiological agents and to analyze the relationship between age, sex, initial diagnosis, preconnection variables with the success-failure rate.

An analytical, observational, retrospective, cross-sectional study was conducted, patients who received HFNC aged 1-48 months (m); Fisher & Paykel Healthcare® Airvo2® equipment Optiflow® infant cannula. Vital signs, TAL score, FiO2, pulse oximetry, O2 liters, SatO2/FiO2 ratio (SaFi) were recorded. Frequency tables and statistical software RMedic12. Chi Square Test of independence; (alpha value =0.05)

The study population was 100 patients, female 34%, male: 66%. Age groups: 1-3 m 34%, 3-6 m 30%, 6-9 m 14%, 9-12 months 15%, 12-48 m: 7% Etiological agents: Respiratory Syncytial Virus 62%, other 38%; Admission diagnoses: Bronchiolitis 81%, others 19%. We obtained overall success in 53% with the following age distribution: 1-3 months 50%, 3-6 m 63%, 6-9 m 36%, 9-12 m 53%, 12-48 m 57.1 %. We found a statistically significant association between therapy/age failure in the group from 6 to 9 months, but not between the variables gender, degree of respiratory compromise, initial diagnosis, etiological agent, SaFi and therapy results.

We propose to expand the implementation of HFNC in low-complexity hospital wards, as an initial alternative, considering that it is not a therapeutical escalation but rather a useful and practical tool. We highlight its advantages such as infrequent complications, high convenience, comfort, low complexity, simple maintenance and ease of FiO2 titration.