Heated Humidified High - Flow Nasal Canula Ventilation For The Treatment Of Severe Pneumonia In Children

Objective To explore the clinical efficacy and safety of heated humidified high-flow nasal cannula(HHFNC)ventilation in the treatment of children with severe pneumonia.Methods Sixty-four patients with severe pneumonia were enrolled into between January 2016 and June 2016,All cases were divided into 2 groups,patients in group 1 were treated with heated humidified high-flow nasal canula treatment group(HHFNC group)and in group 2 were treated with nasal continuous positive airway pressure ventilation treatment group(NCPAP group).Two groups of children were given high-flow nasal canula ventilation therapy and nasal continuous positive airway pressure ventilation therapy on the basis of the same antibiotic resistance to infection and pulverization and sputum suction treatment.The differences of total time on non-invasive ventilation,length of stay in PICU,length of stay and adverse reaction between both groups were compared.Before and after treatment,incidence of nasal mucosal injury,abdominal distention,oxygen partial pressure(Pa O2),saturation(Sp O2)and CO2 partial pressure(Pa CO2),and other indicators of two groups children before and after treatment 0.5 h,24 h,48 h,as well as the complications and outcome of the treatment.Results 1.Sixty-four cases of severe pneumonia children,31 cases in HHFNC group,18 male cases(58.06%)and 13 female cases(41.94%);33 cases in NCPAP group,20 male cases(60.6%)and 13 female cases(39.4%).When the two groups of children admitted to hospital: the weight,age,the ratio of male to female of the two groups were not statistically significant(P > 0.05).2.There is no statistical significance in the comparison differences in ventilator application time,length of PICU stay and length of hospital stay for the two groups(P > 0.05).3.There is no statistical significance in the comparison difference of Pa O2,Pa CO2 and Pa O2/Fi O2 for the two groups at the beginning of the treatment(0 hour)(P > 0.05);0.5h,24 h and 48 h after the treatment,Pa O2,Pa CO2 and Pa O2/Fi O2 for both the HHFNC group and the NCPAP group have been improved.There is statistical significance in the comparison differences at different time within each group except Pa CO2(P < 0.05);Pa CO2 of the HHFNC group has better improvement than the NCPAP group,and there is statistical significance in the comparison differences(P < 0.05);however,there is no statistical significance in the differences of Pa O2/Fi O2 and Sp O2 between the two groups(P > 0.05).4.Comparison of complications and outcome Compared with the NCPAP group,nose injury of the cannula for the HHFNC group is lower,there is statistical significance in the differences between the two group.Two sets of abdominal distension,ventilator rate after nasal airway treatment failure and air leak,death and give up after the death ratio is no significant difference(P > 0.05).Conclusion Heated humidified high flow nasal cannula can improve oxygenation and nasal continuous positive airway pressure ventilation has certain clinical effect in treating children with severe pneumonia.Comparing with NCPAP,HHFNC can reduce the nose injury and Pa CO2.