Chris Novak1,2,3,4, Gemma Vomiero3,4, Allan de Caen1,2, Suzette Cooke3,4. 1. Stollery Children's Hospital, Edmonton, Alberta, Canada. 2. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. 3. Alberta Children's Hospital, Calgary, Alberta, Canada. 4. Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
Abstract
OBJECTIVES: High-flow nasal cannula (HFNC) oxygen therapy has become a common treatment for respiratory conditions in children. To our knowledge, no study has described practice patterns for HFNC on pediatric inpatient wards in Canada. The aim of this study was to survey current practices and policies regarding the use of HFNC on the ward in children's hospitals in Canada. METHODS: We conducted a web-based survey of Pediatric Hospital Medicine section chiefs in major tertiary care hospitals in Canada. The primary outcome was the proportion of hospitals that use HFNC on the general pediatric ward. Secondary outcomes included indications for HFNC, initial and maximum flow rates, maximum FiO2, method of nutrition delivery while on HFNC, level of nursing and respiratory therapist care required, criteria for pediatric intensive care unit transfer, and subjective successes and challenges of implementing a ward-based HFNC policy. RESULTS: The section chief survey response rate was 100% (15/15). Eight centres (53%) allowed the use of HFNC outside of an intensive care setting. Six centres initiated HFNC on the ward, while two centres only accepted patients after HFNC had been initiated in an intensive care setting. Other practices and policies varied considerably from centre to centre. CONCLUSION: Our study reveals that approximately half of tertiary children's hospitals in Canada currently use HFNC on the ward and utilize a range of practices and policies. Other centres are considering implementation. Further research is needed to inform best practices for HFNC therapy, support stewardship of health care resources, and promote safe patient care.
OBJECTIVES: High-flow nasal cannula (HFNC) oxygen therapy has become a common treatment for respiratory conditions in children. To our knowledge, no study has described practice patterns for HFNC on pediatric inpatient wards in Canada. The aim of this study was to survey current practices and policies regarding the use of HFNC on the ward in children's hospitals in Canada. METHODS: We conducted a web-based survey of Pediatric Hospital Medicine section chiefs in major tertiary care hospitals in Canada. The primary outcome was the proportion of hospitals that use HFNC on the general pediatric ward. Secondary outcomes included indications for HFNC, initial and maximum flow rates, maximum FiO2, method of nutrition delivery while on HFNC, level of nursing and respiratory therapist care required, criteria for pediatric intensive care unit transfer, and subjective successes and challenges of implementing a ward-based HFNC policy. RESULTS: The section chief survey response rate was 100% (15/15). Eight centres (53%) allowed the use of HFNC outside of an intensive care setting. Six centres initiated HFNC on the ward, while two centres only accepted patients after HFNC had been initiated in an intensive care setting. Other practices and policies varied considerably from centre to centre. CONCLUSION: Our study reveals that approximately half of tertiary children's hospitals in Canada currently use HFNC on the ward and utilize a range of practices and policies. Other centres are considering implementation. Further research is needed to inform best practices for HFNC therapy, support stewardship of health care resources, and promote safe patient care.
Authors: J Pilar; V Modesto I Alapont; Y M Lopez-Fernandez; O Lopez-Macias; D Garcia-Urabayen; I Amores-Hernandez Journal: Med Intensiva Date: 2017-02-16 Impact factor: 2.491
Authors: Vijay S Gc; Donna Franklin; Jennifer A Whitty; Stuart R Dalziel; Franz E Babl; Luregn J Schlapbach; John F Fraser; Simon Craig; Jocelyn Neutze; Ed Oakley; Andreas Schibler Journal: Arch Dis Child Date: 2020-04-10 Impact factor: 3.791
Authors: Elizabeth Kepreotes; Bruce Whitehead; John Attia; Christopher Oldmeadow; Adam Collison; Andrew Searles; Bernadette Goddard; Jodi Hilton; Mark Lee; Joerg Mattes Journal: Lancet Date: 2017-02-02 Impact factor: 79.321