Details

Autor(en) / Beteiligte

• Schmid, Florian
• Olbertz, Dirk Manfred
• Ballmann, Manfred

Titel

The use of high-flow nasal cannula (HFNC) as respiratory support in neonatal and pediatric intensive care units in Germany – A nationwide survey

Ist Teil von

• Respiratory medicine, 2017-10, Vol.131, p.210-214

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• High-flow nasal cannula (HFNC)1 is a technique of oxygen supply, initially being used as a potentially less-invasive alternative to nasal continuous positive airway pressure (nCPAP)2 for premature infants/neonates, which nowadays crosses the border of neonatal care. HFNC builds up a positive end-expiratory pressure (PEEP)3 but lacks the opportunity for continuous monitoring. Therefore, pressure-depending complications are a risk. Our goal was to evaluate the current use of HFNC in Germany regarding indications, techniques of application and complications experienced. We used a questionnaire sent to 226 pediatric clinics. We received responses from 67 pediatric clinics (29.6%). HFNC was applied in the age group of 8 to 14 years in 42% and between 14 and 18 years in 33% of the clinics. 54% of the clinics have been using HFNC for more than 3 years. Applied flow rates varied strongly among the clinics. 70% of the clinics use HFNC outside of the established indications (alternative to nCPAP for premature infants and neonates, bronchiolitis) for pneumonia, support after extubation and non-adherence to nCPAP. Severe complications such as pneumothorax have been seen by 17,9% of the clinics. We reported for the first time a nationwide overview about the expanded use of HFNC in pediatric clinics. Our results emphasize the fact that, even though HFNC is widely accepted as a non-invasive procedure there is still a potential of severe side effects. Therefore the use of HFNC should be monitored continuously and closely within an intensive or intermediate care unit. •HFNC serves as respiratory support not only on NICUs, but also on PICUs in Germany.•Indications, particularly in older childhood are widening.•Severe pressure-depending side effects have been reported by the hospitals.•Applied flow rates vary strongly among the clinics.