Modified high-flow nasal cannula in young children with pneumonia: A 3-year retrospective study

Objectives: We aimed to report our 3-year experience in modified HFNC (MHFNC) usage in young children with community-acquired pneumonia in infectious diseases ward and to identify factors associated with MHFNC failure. Materials and Methods: A retrospective, cross-sectional study of pediatric patients, aged <5 years, with community-acquired pneumonia, who were treated with MHFNC at infectious diseases from August 2012 to December 2015 were recruited. MHFNC failure was defined as a need for further respiratory support within 48 h after initiating MHFNC. Patients: Ninety-nine patients with community-acquired pneumonia were included in this study. Setting: A tertiary care hospital. Measurements and Results: Ninety-nine children (median age of 14 months, body weight 8.6 + 3.1 kg) were included. Ninety-two children (93%) were successfully treated with MHFNC and only seven (7%) were in the failure group. The maximal flow was 3 L/kg/min. Lower oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (<264) and higher FiO2 requirement were found to be associated with failure. Maximum FiO2 requirement >0.5 had high odds ratios (22.25) to develop MHFNC failure. No serious complication from MHFNC was found. Conclusions: MHFNC is a practical respiratory support in young children with pneumonia. SpO2/FiO2 ratio (<264) and FiO2 requirement >0.5 is a risk factor for MHFNC failure.