Trial identifies most effective breathing support for children in intensive care (Nasal tubes (HFNC) 18% worse than CPAP)

Medical Xpress / Imperial College London / JAMA ^ | Apr. 7, 2022 | Maxine Myers / Padmanabhan Ramnarayan et al

[ConservativeMind]

A commonly used means of delivering extra oxygen to children in intensive care is not as effective as many clinicians assume, new research has found.

It was the first to compare the types of breathing support given to children when they come off mechanical ventilation, to help them transition to breathing unaided.

Comparing methods

The trial compared High-Flow Nasal Cannula therapy (HFNC)—where oxygen is delivered through tubes into the nostrils—with Continuous Positive Airwave Pressure (CPAP)—for which patients wear an oxygen mask. HFNC has become increasingly popular in pediatric intensive care units, as it is seen as more comfortable for children to tolerate.

However, when the two methods were compared, the researchers found that children on HFNC needed breathing support for up to 18 hours longer than those using CPAP.

Dr. Ramnarayan, who also works as a consultant in pediatric intensive care at Imperial College Healthcare NHS Trust, said, "We know that HFNC can't deliver the same levels of breathing support as CPAP, but it's been assumed that the reduced effectiveness is a price worth paying for the additional comfort it provides. Our results show that may not be the case."

The trial showed that children on average spent 43 hours on breathing support with CPAP, and 51 with HFNC, eight hours longer. However, for some, the additional time was as much as 18 hours, breaching the trial's upper limit.

Dr. Ramnarayan added, "Most pediatricians have tended to prefer HFNC, but these results are likely to make them more cautious.

[ConservativeMind]

Kids might prefer the standard oxygen, but they do better on CPAP.

[ConservativeMind]

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[Do_Tar]

Anecdotally, I’ve notice I tend to take deeper breaths when using my CPAP.

[thinden]

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