• Adriana Wegner A, Pamela Cespedes F, María Loreto Godoy M, Pedro Erices B, Luis Urrutia C, Carina Venthur U, Marcela Labbé C, Hugo Riquelme M, Cecilia Sanchez J, Waldo Vera V, David Wood V, Juan Carlos Contreras C, and Efren Urrutia S.
• Pediatra Intensivista, Unidad de Paciente Crítico Pediátrico (UPCP), Complejo Asistencial Dr. Sotero del Río, Santiago, Chile. Electronic address: awegnera@gmail.com.
• Rev Chil Pediatr. 2015 May 1; 86 (3): 173-81.

IntroductionThe high flow nasal cannula (HFNC) is a method of respiratory support that is increasingly being used in paediatrics due to its results and safety.ObjectiveTo determine the efficacy of HFNC, as well as to evaluate the factors related to its failure and complications associated with its use in infants.Patients And MethodAn analysis was performed on the demographic, clinical, blood gas, and radiological data, as well as the complications of patients connected to a HFNC in a critical care unit between June 2012 and September 2014. A comparison was made between the patients who failed and those who responded to HFNC. A failure was considered as the need for further respiratory support during the first 48hours of connection. The Kolmogorov Smirnov, Mann-Whitney U, chi squared and the Exact Fisher test were used, as well as correlations and a binary logistic regression model for P≤.05.ResultsThe study included 109 patients, with a median age and weight: 1 month (0.2-20 months) and 3.7kg (2-10kg); 95 percentile: 3.7 months and 5.7kg, respectively. The most frequent diagnosis and radiological pattern was bronchiolitis (53.2%) and interstitial infiltration (56%). Around 70.6% responded. There was a significant difference between failure and response in the diagnosis (P=.013), radiography (P=018), connection context (P<.0001), pCO2 (median 40.7mmHg [15.4-67 mmHg] versus 47.3mmHg [28.6-71.3mmHg], P=.004) and hours on HFNC (median 60.75hrs [5-621.5 hrs] versus 10.5hrs [1-29 hrs], P<.0001). The OR of the PCO2 ≥ 55mmHg for failure was 2.97 (95% CI; 1.08-8.17; P=.035). No patient died and no complications were recorded.ConclusionThe percentage success observed was similar to that published. In this sample, the failure of HFNC was only associated with an initial pCO2 ≥ 55mmHg. On there being no complications reported as regards it use, it is considered safe, although a randomised, controlled, multicentre study is required to compare and contrast these results.Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

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