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A Review of Heated High-Flow Nasal Cannula in Pediatrics—From Critical Care to Ward Use

  • Hospital Medicine (A Statile and N Unaka, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of review

Heated high-flow nasal cannula (HFNC) is used in management of acute respiratory distress and is increasingly used in the emergency department (ED) and ward setting. This review aimed to highlight existing literature on ward use of HFNC.

Recent findings

HFNC reduces work of breathing, increases mucociliary clearance, and improves oxygenation. Within limits, HFNC can be safely used on pediatric wards for management of moderate to severe respiratory distress. Weight-based and non-weight-based flow rates have been successfully used on pediatric wards, and maximum acceptable flow rates on wards are site and resource specific. Frequent monitoring can identify responders and non-responders requiring escalation. Early observation suggests that oral feeding is safe. Ward HFNC weaning protocols are lacking.

Summary

Evidence suggests that in selected populations of children with moderate to severe respiratory distress due to acute bronchiolitis, HFNC with close monitoring is safe for use on the pediatric wards.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Author information

Authors and Affiliations

  1. Division of Pediatric Hospital Medicine, Department of Pediatrics, Children’s National Health System, 111 Michigan Ave Suite 4800, Washington, DC, 20010, USA

    Sonal Kalburgi DO, MSHS & Tina Halley MD

  2. Division of Hospital Based Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Box 152, Chicago, IL, 60611-2605, USA

    Irini N. Kolaitis MD

  3. Department of Respiratory Care, Children’s Health System of Texas, 1935 Medical District Drive, Dallas, TX, 75235, USA

    Kristen Hood RRT

  4. Division of Hospital Medicine, Department of Pediatrics, UT Southwestern Medical Center and Children’s Health System of Texas, 1935 Medical District Drive, Dallas, TX, 75235, USA

    Vineeta Mittal MD MBA

Authors
  1. Sonal Kalburgi DO, MSHS
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  2. Tina Halley MD
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  3. Irini N. Kolaitis MD
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  5. Vineeta Mittal MD MBA
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Corresponding author

Correspondence to Vineeta Mittal MD MBA.

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Conflict of Interest

Sonal Kalburgi declares that she has no conflicts of interest. Tina Halley declares that she has no conflicts of interest. Irini N. Kolaitis declares that she has no conflicts of interest. Kristen Hood declares that she has no conflicts of interest. Vineeta Mittal declares that she has no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hospital Medicine

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Kalburgi, S., Halley, T., Kolaitis, I.N. et al. A Review of Heated High-Flow Nasal Cannula in Pediatrics—From Critical Care to Ward Use. Curr Treat Options Peds 4, 319–329 (2018). https://doi.org/10.1007/s40746-018-0128-x

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  • DOI: https://doi.org/10.1007/s40746-018-0128-x

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