Use of High Flow Nasal Cannula in Children

Abstract

The use of high flow nasal cannula (HFNC), also often called Heated Humidified High Flow Nasal Cannula (HHHFNC) is a relatively new non-invasive therapy. HFNC was firstly introduced to treat premature babies as an alternative to CPAP, but recently there has been an increase number of HFNC using in children and adults care. However, the evidence for the safety and effectiveness of HFNC as respiratory support in children is still lacking.  Studies of the effects of HFNC was identified to have positive clinical effects on SpO2, PaO2, respiratory rate and blood gas analysis parameters in some children, especially children with bronchiolitis. Most clinical studies in children are observational studies in infants with bronchiolitis. Various positive clinical effects on various respiratory parameters have been found, reducing work of breathing, reducing the need for CPAP and invasive ventilation in infants and children. Until more and more available evidence, HFNC can be used as an additional form of breathing assistance in infants and children, but with a clinical approach based on clinical responses and safety issues that are associated with the introduction of earlier treatment failures especially in children treated with HFNC outside the PICU.