High-flow nasal cannula in Spanish Pediatric Intensive Care Services: A national web survey about its use and indications

IF 2.7 4区 医学 Q2 CRITICAL CARE MEDICINE
Alberto García-Salido , Vicente Modesto I Alapont , Alberto Medina-Villanueva , Spanish respiratory group of the Spanish Society of Pediatric Intensive Care
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引用次数: 0

Abstract

Objective

To describe the high-flow nasal cannula (HFNC) indications in the Spanish pediatric critical care units (PICUs).

Design

Descriptive cross-sectional observational study.

Setting

Electronic survey among members of the Spanish Society of Pediatric Intensive Care (SECIP). It was sent weekly from April 10, 2023, to May 21, 2023.

Participants

All SECIP members.

Interventions

None.

Main variables of interest

The questions focused on workplace, years of experience, use or non-use of HFNC, justification and expectations regarding its application, starting point within each center, clinical criteria for indication, existence of clinical guidelines, evaluation during its use, and criteria and mode of withdrawal.

Results

Two hundred and two participants, 176 were from Spain. Of these, 87/176 had over ten years of experience. One hundred sixty two use HFNC and 66/162 have HFNC clinical guidelines. Acute bronchiolitis (138/162) and respiratory assistance after extubation (106/56) are the two main indications. For 62/162 HFNC may reduce therapeutic escalation. Neuromuscular diseases (105/162) and anatomical airway diseases (135/162) are the two main contraindications. The reasons to do not use HFNC were the absence of evidence about it effectiveness (8/14) and its inadequate cost/effectiveness balance (8/14).

Conclusions

A majority of Spanish pediatric intensivists use HFNC. Its application and withdrawal appears to be primarily based on clinical experience. Besides, those who use HFNC are aware of its limitations and the lack of evidence in some cases. It is necessary to develop single-center and multicenter studies to elucidate the effectiveness of this therapy in the context of critically ill children.

Abstract Image

西班牙儿科重症监护服务中的高流量鼻插管:关于其使用和适应症的全国性网络调查
目标描述西班牙儿科重症监护病房(PICU)中高流量鼻插管(HFNC)的适应症.设计描述性横断面观察研究.设置对西班牙儿科重症监护协会(SECIP)成员进行电子调查.从 2023 年 4 月 10 日至 2023 年 5 月 21 日,每周发送一次调查问卷.参与者所有 SECIP 成员.干预措施无.主要关注变量问题集中在工作场所、经验年限、使用情况等方面.主要关注变量问题主要涉及工作场所、工作年限、是否使用 HFNC、使用 HFNC 的理由和期望、每个中心的起始点、适应症的临床标准、是否存在临床指南、使用期间的评估以及停用的标准和方式。结果222 名参与者中有 176 名来自西班牙。其中 87/176 人有十年以上的使用经验。162 人使用 HFNC,66/162 人有 HFNC 临床指南。急性支气管炎(138/162)和拔管后呼吸辅助(106/56)是两个主要适应症。62/162 例 HFNC 可减少治疗升级。神经肌肉疾病(105/162)和气道解剖疾病(135/162)是两个主要禁忌症。不使用 HFNC 的原因是缺乏有关其有效性的证据(8/14)以及其成本/效益平衡不足(8/14)。大多数西班牙儿科重症监护医师都使用 HFNC,其使用和停用似乎主要基于临床经验。此外,使用 HFNC 的医生也意识到其局限性以及在某些情况下缺乏证据。有必要开展单中心和多中心研究,以阐明这种疗法在重症儿童中的有效性。
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来源期刊
Medicina Intensiva
Medicina Intensiva CRITICAL CARE MEDICINE-
CiteScore
2.70
自引率
20.00%
发文量
146
审稿时长
33 days
期刊介绍: Medicina Intensiva is the journal of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) and of Pan American and Iberian Federation of Societies of Intensive and Critical Care Medicine. Medicina Intensiva has become the reference publication in Spanish in its field. The journal mainly publishes Original Articles, Reviews, Clinical Notes, Consensus Documents, Images, and other information relevant to the specialty. All works go through a rigorous selection process. The journal accepts submissions of articles in English and in Spanish languages. The journal follows the publication requirements of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).
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