Oxigenoterapia de alto flujo en cánulas nasalesempleo en una planta de hospitalización

Abstract

Objective: The high-flow nasal cannula (HFNC) oxygen therapy is a respiratory support usually used in intensive care units. In our hospital we used it in the pediatric ward (infants and children) since April 2009. Our aim is to test the clinical out­comes, security, and assess the acceptance of its use by the nursing service. Patients and methods: We reviewed the use of HFNC in acute respiratory failure (ARF) during 2011, establishing three groups: G1, bronchiolitis; G2, children under 2 years with previous episodes, and G3, children over 2 years with previous episodes. Prospectively, we assessed the severity of the ARF, comparing the improvement of the patients, considering the transition of severe distress to moderate distress at 6 respectively 12 hours of the clinical onset. We also realized a survey to all the paediatric ward nurses about their perception of the HFNC (installation and maintenance, interference with medications, diet, side effects, tolerance...). Results: In our study, 33 patients received HNCF. We saw an improvement in all three groups (p <0.001), without significant differences between them. Taking separately, we found an improvement in each one of them, G1 (p <0.001), G2 (p= 0.003) and G3 (p= 0.006). The perception of nursing about the HFNC is that it's easy to apply, so generally, they had a positive impression about this respiratory support. Conclusions: The HFNC it's a respiratory support with obvious clinical benefits, easy to use, well accepted by nurses and, as we think, applicable in a hospital ward. Anyway, we mustn't forget that are critically patients requiring maximum vigilance and that not all of them respond favorably.