ArticleHospital pediatrics2023
The Current State of High-Flow Nasal Cannula Protocols at Children's Hospitals.
Article in Hospital pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Transition to Weight-Based High-Flow Nasal Cannula Use Outside of the ICU for Bronchiolitis.JAMA network open · 2024Article
- Nasal CPAP in the Pediatric Ward to Reduce PICU Admissions for Severe Bronchiolitis?Pediatric reports · 2023Article
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo describe the current state of non-ICU high flow nasal cannula (HFNC) protocols at children's hospitals and explore associations between HFNC protocol type and utilization outcomes.
methodsWe performed a cross-sectional study of the Pediatric Health Information Systems (PHIS) database. First, we designed a survey with the purpose of classifying HFNC protocols used at hospitals currently contributing data to PHIS. Next, we categorized hospitals based on their current HFNC protocol (ICU only, age-based non-ICU, or weight-based non-ICU). Finally, using the PHIS database, we compared hospital characteristics and patient-level bronchiolitis outcomes by HFNC protocol group.
resultsWe received survey responses from 36 of 44 (82%) hospitals contributing data to PHIS in 2021. During the time period studied, there was a steady increase in adoption of non-ICU HFNC protocols, with 71% of responding children's hospitals reporting non-ICU HFNC protocols in 2021 compared with 11% before 2010. No differences in hospital characteristics were observed between ICU-only hospitals, age-based hospitals, or weight-based hospitals. Age-based hospitals had the highest proportion of bronchiolitis patients treated in the ICU (36.1%), whereas weight-based hospitals had the lowest proportion of patients treated in the ICU (21.0%, P < .001). Length of stay was longer at age-based hospitals (2.9 days) as compared with weight-based and ICU-only hospitals (1.9 days, P < .001).
conclusionsMost children's hospitals have adopted non-ICU HFNC protocols for patients with bronchiolitis, the majority of which are now utilizing weight-based maximum flow rates. Weight-based HFNC protocols were associated with decreased ICU utilization compared with age-based HFNC protocols.
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