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Nasopharyngeal Airway Pressures in Bronchiolitis Patients Treated With High-Flow Nasal Cannula Oxygen Therapy.
MedLine Citation:
PMID:  23114244     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Heated, humidified, high-flow nasal cannula oxygen therapy (HHHFNC) has been used to improve ventilation in preterm infants. There are no data on airway pressures generated and efficacy in bronchiolitis. OBJECTIVE: The objective of this study was to determine nasopharyngeal (NP) pressures generated with HHHFNC therapy in bronchiolitis. METHODS: We conducted a prospective, observational study to measure NP pressures at varying flow rates of HHHFNC therapy in moderate to severe bronchiolitis. Vital signs, bronchiolitis severity scores, and oxygen saturation were also noted. RESULTS: Twenty-five patients were enrolled (mean, 78.1 [SD, 30.9] days; weight, 5.3 [SD, 1.1] kg). Nasopharyngeal pressures increased linearly with flow rates up to 6 L/min. Beyond 6 L/min, pressure increase was linear but less accelerated. On average, NP pressure increased by 0.45 cm H2O for each 1-L/min increase in flow rate. There were significant differences between pressures in open- and closed-mouth states for flow rates up to 6 L/min. At 6 L/min, the pressure in open-mouth state was 2.47 cm H2O and that in closed-mouth state was 2.74 cm H2O (P < 0.001). Linear regression analysis revealed that only flow (not weight or gender) had an effect on generated pressure. Bronchiolitis severity scores improved significantly with HHHFNC therapy (pre: 14.5 [SD, 1.4], post: 10.4 [SD, 1.2]; P < 0.001). CONCLUSIONS: Increasing flow rates of HHHFNC therapy are associated with linear increases in NP pressures in bronchiolitis patients. Larger studies are needed to assess the clinical efficacy of HHHFNC therapy in bronchiolitis.
Authors:
Bhawana Arora; Prashant Mahajan; Marwan A Zidan; Usha Sethuraman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-30
Journal Detail:
Title:  Pediatric emergency care     Volume:  -     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-11-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the *Department of Pediatric Emergency Medicine and †Carman & Ann Adams Department of Pediatrics, Children's Hospital of Michigan; and ‡Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
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