- High-flow nasal cannula (HFNC) reduced treatment failure in children aged
- However, when compared with nasal continuous positive airway pressure (nCPAP), HFNC was associated with higher treatment failure in infants aged 1-6 months with moderate-to-severe respiratory distress from bronchiolitis, pneumonia, sepsis, asthma and upper airway obstruction.
Why this matters
- Observational studies have suggested that HFNC may improve oxygenation and reduce the need for mechanical ventilation in children with respiratory distress.
- Meta-analysis of 8 randomised controlled studies including 2259 patients who were assigned to HFNC (n=1100), standard oxygen (n=980) or nCPAP (n=179) therapy after a search across PubMed, Embase, Medline, and other electronic databases.
- Main outcome: probability of treatment failure.
- Funding: None.
- HFNC vs standard oxygen therapy significantly reduced the probability of treatment failure (risk ratio [RR], 0.49; 95% CI, 0.40-0.60; P<.001 in children aged years with mild hypoxaemia from bronchitis or pneumonia. style="list-style-type:circle;">
- After stratification for age, HFNC was superior to standard therapy for:
- infants aged 1-6 months: RR, 0.53; 95% CI, 0.40-0.69; P<.001>
- infants aged 6-12 months: RR, 0.47; 95% CI, 0.33-0.67; P<.001 and>
- children aged 1-5 years: RR, 0.37; 95% CI, 0.16-0.83; P=.02.
- After stratification for age, nCPAP was superior to HFNC therapy for:
- infants aged 1-6 months: RR, 1.77; 95% CI, 1.17-2.67; P=.007,
- infants aged 6-12 months: RR, 1.46; 95% CI, 0.30-7.17; P=.64 and
- children aged 1-5 years: RR, 0.74; 95% CI, 0.07-7.63; P=.80.
- Limited number of studies.
- Risk of heterogeneity.