• M RogersonColinCIndiana University School of Medicine, Indianapolis, Indiana; and Regenstrief Institute Center for Biomedical Informatics, Indianapolis, Indiana. crogerso@iupui.edu., E CarrollAaronAIndiana University School of Medicine, Indianapolis, Indiana., Wanzhu Tu, Tian He, K SchleyerTitusTIndiana University School of Medicine, Indianapolis, Indiana; and Regenstrief Institute Center for Biomedical Informatics, Indianapolis, Indiana., M RowanCourtneyCIndiana University School of Medicine, Indianapolis, Indiana., H OworaArthurADepartment of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, Indiana., and A MendoncaEneidaEIndiana University School of Medicine, Indianapolis, Indiana; and Regenstrief Institute Center for Biomedical Informatics, Indianapolis, Indiana..
• Indiana University School of Medicine, Indianapolis, Indiana; and Regenstrief Institute Center for Biomedical Informatics, Indianapolis, Indiana. crogerso@iupui.edu.
• Respir Care. 2022 Aug 1; 67 (8): 976984976-984.

BackgroundHeated humidified high-flow nasal cannula (HFNC) is a respiratory support device historically used in pediatrics for infants with bronchiolitis. No large-scale analysis has determined the current frequency or demographic distribution of HFNC use in children. The objective of this study was to determine the frequency and correlates of HFNC use in children presenting to the hospital for asthma, bronchiolitis, or pneumonia.MethodsThis longitudinal observational study was based on electronic health record data from a large regional health information exchange, the Indiana Network for Patient Care (INPC). Subjects were age 0-18 y with recorded hospital encounters at an INPC hospital between 2010-2019 with International Classification of Diseases codes for bronchiolitis, asthma, or pneumonia. Annual proportions of HFNC use among all hospital encounters were assessed using generalized additive models. Log-binomial regression models were used to identify correlates of incident HFNC use and determine risk ratios of specific subjects receiving HFNC.ResultsThe study sample included 242,381 unique subjects with 412,712 hospital encounters between 2010-2019. The 10-y period prevalence of HFNC use was 2.54% (6,155/242,381) involving 7,974 encounters. Hospital encounters utilizing HFNC increased by 400%, from 326 in 2010 to 1,310 in 2019. This increase was evenly distributed across all 3 diagnostic categories (bronchiolitis, asthma, and pneumonia). Sex, race, age, and ethnicity all significantly influenced the risk of HFNC use. Over the 10-y period, the percentage of all hospital encounters using HFNC increased from 1.11% in 2010 to 3.15% in 2018. Subjects with multiple diagnoses had significantly higher risk of receiving HFNC.ConclusionsThe use of HFNC in children presenting to the hospital with common respiratory diseases has increased substantially over the past decade and is no longer confined to treating infants with bronchiolitis. Demographic and diagnostic factors significantly influenced the frequency of HFNC use.Copyright © 2022 by Daedalus Enterprises.

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