High Flow Nasal Cannula Therapy as a Primary Mode of Respiratory Support in a Pediatric Intensive Care Unit

Objective To assess efficacy and safety of High flow nasal cannula therapy (HFNC) as primary mode of treatment for children with respiratory distress. Methods Consecutive patients (1 mo-16 years) with respiratory distress were assessed for respiratory clinical score, COMFORT score and saturation to FiO(2) (SF) ratio. Results A total of 188 (91.7%) patients out of 205 responded to HFNC alone. The respiratory clinical score and COMFORT score were lower with higher SF ratio in these than 17 patients who required ventilation (P<0.001). Median (IQR) time to failure was 2 (1.75-24) hours. Air leak was seen in 2 (1%) patients. Conclusions HFNC is an effective and safe primary mode of respiratory support in children with respiratory distress. Children who succeed on HFNC show a favorable clinical response within first few hours.