High flow nasal cannula vs non-invasive ventilation in pediatric ARDS: an RCT
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2018, Vol 5, Issue 11
Abstract
Introduction: Pediatric Acute Respiratory Distress syndrome (PARDS) has been re-defined (2015) as per the final recommendations of the Pediatric Acute Lung Injury Consensus Conference. The use of high flow nasal cannula is a promising treatment but its efficacy compared with non invasive ventilation (NIV) is not known.Aims and Objectives: The current study was undertaken to study the efficacy of high flow nasal cannula compared with NIV in PARDS. Methods: This was a pilot randomized controlled trial done in the PICU of a tertiary care teaching hospital over 10 months (December 2017 – September 2018). All patients aged 1-18 years of age, who presented with or developed ARDS during their course of hospitalization, and who fulfilled the inclusion criteria, were randomized to receive HFNC and Continuous Positive Airway Pressure (NIV) as the initial respiratory support.Details were noted in a pre-designed standardized data collection form, entered into MS-EXCEL worksheet 2013 and analyzed using the Epi info software version 7.2.0.1. Results: A total of 40 patients were enrolled, 20 in each arm.Of these majority (25/40=62.5%) were boys. Majority of these patients were from rural or semi-urban areas (28/40=70.0%) and belonged to low socio-economic class (33/40= 82.5%) patients.Underlying diagnosis was sepsis in the majority (27/40=67.5%) patients.Twenty one (23/40=57.5%) patients had co-existent pneumonia.Development of hemodynamic instability approached statistical significance in being low in HFNC group compared with the CPAP group (p=0.07; OR 0.206, 95% CI 0.036-0.159).Subsequent requirement of invasive ventilation was also low in HFNC group compared with CPAP group and approached significance (p=0.09; OR 1.653, 95% CI 0.074-1.246). Total duration of respiratory support (p=0.62) was comparable in both the groups. Conclusion: HFNC is efficacious in managing PARDS. Subsequent requirement of invasive ventilation and hemodynamic deterioration was significantly low with HFNC compared with NIV (CPAP).
Authors and Affiliations
Surabhi Chandra, Vijayshri Vijayshri, Aditi Gupta, Pratishtha Goyal, P. L. Prasad
Keywords
Related Articles
- EP ID EP496151
- DOI 10.17511/ijpr.2018.11.07
- Views 193
- Downloads 0
A study on intima- media thickness of carotid artery in children withnephrotic syndrome: a cross sectional study
Introduction: Atherosclerosis is one of the complications of Nephrotic syndrome. It is due to frequent exposure to hyperlipidemia, hypertension, and hypoproteinemia, steroid and immunosuppressive therapy may also contrib...
Clinical profile of patients admitted to the PICU of a tertiary care teaching hospital
Introduction: There is a dearth of data on the clinical and etiological spectrum of PICU (Pediatric Intensive Care Unit) admissions from India, especially from post graduation teaching institutes. Aim: The current study...
Modifiable risk factors for acute lower respiratory tract infections in hospital admitted children between 2 months to 5 years of age
Introduction: Acute respiratory infections (ARI) are known to cause morbidity and mortality from time immemorial. Acute respiratory infections (ARI) are the most important single cause of global burden of disease in youn...
Prevalence of obesity in school children aged 11-15 years in western district of Tamil Nadu
Introduction:Obesity in children and adolescents is an important public health problem in India. This study was done to estimate the prevalence of obesity in 11-15 years urban school children using Body mass index. (BMI)...
Magnitude and clinico-etiological profile of renal disorders in children – a retrospective study in tertiary care hospital
Objectives: This study was undertaken to know about the magnitude, clinical spectrum and etiologyof renal diseases in children in a tertiary care teaching hospital. Materials and Methods: Thisis a hospital based, retrosp...