Protocolo de cuidados con Cánula Nasal de Alto Flujo en unidades de cuidados intensivos pediátricos

Nicole Astrhid García Rivera; Jairo Santiago León Lagos; Paolina Antonieta Figuera Ávila; Indyra Emma Gallard Muñoz

doi:10.37431/conectividad.v5i4.188

Authors

Nicole Astrhid García Rivera Universidad Iberoamericana del Ecuador https://orcid.org/0009-0008-1744-2530
Jairo Santiago León Lagos Universidad Iberoamericana del Ecuador https://orcid.org/0009-0005-1159-6561
Paolina Antonieta Figuera Ávila Universidad Iberoamericana del Ecuador https://orcid.org/0000-0002-7270-4408
Indyra Emma Gallard Muñoz Universidad Iberoamericana del Ecuador https://orcid.org/0000-0003-1236-7363

DOI:

https://doi.org/10.37431/conectividad.v5i4.188

Keywords:

high flow nasal cannula, pediatric patient, intensive care units

Abstract

Introduction: High-flow nasal cannula (HFNC) is a noninvasive ventilation modality used in the pediatric population. Benefits are described for oxygenation, ventilation, and patient comfort, so knowing the most effective protocols is of interest. The objective is to analyze the most effective care protocols for HFNC therapy in pediatric intensive care units (PICUs). The methodology is qualitative, with a systematic review design, following the proposal of Kitchenham & Charters (2007) and the PICO format, under the PRISMA 2020 document review method. Results: Weight-based HFNC protocols are associated with lower PICU utilization compared to age-based protocols. HFNC has been shown to be superior to therapeutic oxygen delivery and noninvasive ventilation in terms of reducing the risk of treatment escalation and improving clinical parameters. Conclusion: The introduction of standardized protocols has allowed for a reduction in both the duration of HFNC use and the length of stay in the ICU. However, the effectiveness of these protocols varies, so it is important to evaluate their impact in different clinical settings.

References

Alexander, E. C., Wadia, T. H., & Ramnarayan, P. (2024). Effectiveness of high flow nasal Cannula (HFNC) therapy compared to standard oxygen therapy (SOT) and continuous positive airway pressure (CPAP) in bronchiolitis. Paediatric Respiratory Reviews. https://doi.org/10.1016/j.prrv.2024.05.004

Artacho Ruiz, R., Artacho Jurado, B., Caballero Güeto, F., Cano Yuste, A., Durbán García, I., García Delgado, F., Guzmán Pérez, J. A., López Obispo, M., Quero del Río, I., Rivera Espinar, F., & del Campo Molina, E. (2019). Predictores de éxito del tratamiento con cánula nasal de alto flujo en el fallo respiratorio agudo hipoxémico. 45, 80-87. https://doi.org/10.1016/j.medin.2019.07.012

Balleda, L., Kolla, S., & Thimmapuram, C. R. (2024). To study the efficiency of high-flow nasal cannula in improving the arterial blood gas parameters in children admitted to pediatric intensive care unit with respiratory distress. Pediatric Respirology and Critical Care Medicine, 8(1), 16. https://doi.org/10.4103/prcm.prcm_25_23

Castro, A., Moisés, J., & Sousa, D. (2023). Analysis of the Experience in the Use of the High-Flow Nasal Cannula as Therapeutics in SARS-CoV-2 Pneumonia. 23.

Castro Soplin, K. L. (2023). Cánula de alto flujo e índice de Rox en pacientes con covid-19 en un hospital nivel III de Lima, 2022. https://repositorio.uwiener.edu.pe/handle/20.500.13053/9310

Clayton, J. A., Slain, K. N., Shein, S. L., & Cheifetz, I. M. (2022). High flow nasal cannula in the pediatric intensive care unit. Expert Review of Respiratory Medicine, 16(4), 409-417. https://doi.org/10.1080/17476348.2022.2049761

Colaianni Alfonso, N., & Castro Sayat, M. (2019). Cánula Nasal Alto-Flujo (CNAF): Puesta al día. Archivos de medicina, 15(4), 4. https://dialnet.unirioja.es/servlet/articulo?codigo=7208785

Díaz, P., Domichin, F., & Bartoli, J. (2022). Cánula nasal de alto flujo para el tratamiento de la insuficiencia respiratoria aguda hipoxémica por COVID-19: Un estudio retrospectivo. Revista Methodo: Investigación Aplicada a las Ciencias Biológicas, 7(2), 51-62. https://dialnet.unirioja.es/servlet/articulo?codigo=8447132

García-Salido, A., Modesto I Alapont, V., & Medina-Villanueva, A. (2024). High-flow nasal cannula in Spanish Pediatric Intensive Care Services: A national web survey about its use and indications. Medicina Intensiva (English Edition). https://doi.org/10.1016/j.medine.2024.03.012

Huaman, D. E. V. (2021). Conocimiento y práctica de automedicación en pobladores de la comunidad de Lurigancho—Chosica 202 [Tesis de pregrado, Universidad Ricardo Palma]. https://hdl.handle.net/20.500.14138/4571

İleri, G., Zengin, N., & Bal, A. (2022). Evaluation of Efficacy and Failure of High Flow Nasal Cannula Therapy in Paediatric Emergency Service and Paediatric Intensive Care Unit: High Flow Nasal Cannula Therapy In Paediatric Settings. Medical Science and Discovery, 9(4), Article 4. https://doi.org/10.36472/msd.v9i4.713

Kitchenham, B., & Charters, S. (2007). Guidelines for performing Systematic Literature Reviews in Software Engineering. 2.

Koçoğlu Barlas, Ü., Özel, A., Tosun, V., Ufuk Bozkurt, E., & Serdar Kıhtır, H. (2024). Comparison of the Efficacies of High-Flow Nasal Cannula Oxygen Therapy and Non-invasive Nasal Cannula Ventilation in Preventing Intubation. Turkish Archives of Pediatrics, 59(2), 214-220. https://doi.org/10.5152/TurkArchPediatr.2024.23301

Maue, D. K., Cater, D. T., Rogerson, C. M., Ealy, A., Tori, A. J., & Abu-Sultaneh, S. (2023). Outcomes of a respiratory therapist driven high flow nasal cannula management protocol for pediatric critical asthma patients. Pediatric Pulmonology, 58(10), 2881-2888. https://doi.org/10.1002/ppul.26606

Morris, L., Cook, N., Ramsey, A., Alacapa, J. V., Smith, L. E., Gray, C., Craft, J. A., Chin, R., & Christensen, M. (2020). Weaning Humidified High Flow Oxygen Therapy among Paediatric Patients: An Integrative Review of Literature. Journal of Pediatric Nursing, 50, 37-45. https://doi.org/10.1016/j.pedn.2019.10.015

Nishikawa-Pacher, A. (2022). Research Questions with PICO: A Universal Mnemonic. Publications, 10(3), Article 3. https://doi.org/10.3390/publications10030021

Page, M., McKenzie, J., Bossuyt, P. M., & Boutron. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. 372(71). https://doi.org/10.1136/bmj.n71

Palencia-Mojica, C. L., Valero-Ortiz, A. S., Silva-Rodríguez, L. J., Palencia-Mojica, C. L., Valero-Ortiz, A. S., & Silva-Rodríguez, L. J. (2020). Comportamiento clínico y gasométrico en falla respiratoria aguda tratada con cánula nasal de alto flujo. Universidad y Salud, 22(2), 102-111. https://doi.org/10.22267/rus.202202.181

Paz Alvarez, L. A., Peralta Campos, Y., Casado Díaz, S., Figueroa Pérez, E., Pérez Alvarez, O. L., Paz Alvarez, L. A., Peralta Campos, Y., Casado Díaz, S., Figueroa Pérez, E., & Pérez Alvarez, O. L. (2020). Manejo de la bronquiolitis aguda en el servicio de neumología pediátrica de Pinar del Río. Revista de Ciencias Médicas de Pinar del Río, 24(5). http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1561-31942020000500007&lng=es&nrm=iso&tlng=es

Pilar Orive, F. J., & López Fernández, Y. M. (2021). Alto flujo. 1, 235-243. https://www.aeped.es/sites/default/files/documentos/18_alto_flujo.pdf

Piracoca Mejía, J., Pardo, R., Ruiz, D., & Casallas. (2019). Principales desenlaces clínicos en lactantes menores con insuficiencia respiratoria aguda tratados con cánula nasal de alto flujo en una unidad de cuidado intensivo pediátrico de Bogotá, 2016 -2017 [Tesis de Maestría, Universidad del Rosario]. https://repository.urosario.edu.co/server/api/core/bitstreams/eff60d1a-5396-48df-b555-e546bde38f41/content

Plotnikow, G. A., Accoce, M., Navarro, E., & Tiribelli, N. (2018). Acondicionamiento del gas inhalado en pacientes con vía aérea artificial. 30(1). https://doi.org/10.5935/0103-507X.20180015

Ramnarayan, P., Richards-Belle, A., Drikite, L., Saull, M., Orzechowska, I., Darnell, R., Sadique, Z., Lester, J., Morris, K. P., Tume, L. N., Davis, P. J., Peters, M. J., Feltbower, R. G., Grieve, R., Thomas, K., Mouncey, P. R., Harrison, D. A., Rowan, K. M., & FIRST-ABC Step-Up RCT Investigators and the Paediatric Critical Care Society Study Group. (2022). Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA, 328(2), 162-172. https://doi.org/10.1001/jama.2022.9615

Spindola, R. (2023). Oxigenoterapia y Cánula nasal de alto flujo en pediatría. Salud, Ciencia y Tecnología, 2(1). https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=109237

Volakli, E., Menelaos, S., Asimina, V., Chochliourou, E., Kalamitsou, S., Avramidou, V., Katsafiloudi, M., Iordanidou, D., Karantaglis, N., & Sdougka, M. (2022). High flow nasal cannula therapy in children: Working principles and treatment failure predictors. 18(6), 5-16. https://doi.org/10.22514/sv.2022.039

Wegner, A. (2017). CÁNULA NASAL DE ALTO FLUJO EN PEDIATRÍA. 12(1), 5-8. http://www.prematuro.cl/subespecialidadesneonatales/Infectologia/Vrs/VRS/Canula_nasal_Alto_flujo_Wegner_2017.pdf

Willer, R. J., Brady, P. W., Tyler, A. N., Treasure, J. D., & Coon, E. R. (2023). The Current State of High-Flow Nasal Cannula Protocols at Children’s Hospitals. Hospital Pediatrics, 13(5), e109-e113. https://doi.org/10.1542/hpeds.2022-006969