Author Of 1 Presentation

 CONFERENCE CALENDAR

HIGH FLOW NASAL CANNULA OXYGEN THERAPY OUTSIDE THE PICU IN PEDIATRIC CANCER AND HEMATOPOIETIC STEM CELL TRANSPLANT PATIENTS WITH ACUTE HYPOXEMIC RESPIRATORY FAILURE.

Presenter
Authors
Room
Poster Area 2
Date
20.06.2019
Session Time
12:20 - 13:40
Session Name
POSTER WALK SESSION 07
Duration
5 Minutes

Abstract

Background

Acute respiratory failure is a major cause of pediatric intensive care unit (PICU) admission in pediatric cancer and hematopoietic stem cell transplant (HSCT) patients. The use of high-flow nasal cannula oxygen therapy (HFNC) is growing as an alternative to standard oxygen. However, its use in patients treated for malignancies including HSCT, is controversial.

Objectives

The aim of this study was to assess outcomes of pediatric cancer and HSCT patients (including non-malignant indications) with acute hypoxemic respiratory failure treated with high-flow nasal oxygen on the ward.

Methods

In this retrospective cohort study, pediatric cancer and (non)-cancer HSCT patients with acute hypoxemic respiratory failure treated with HFNC were included. Among 39 patients included in the study, 53 episodes of HFNC treatment were analyzed. Of these episodes, 18 (34%) failed and patients required subsequently PICU admission. A significant median higher CRP (175 (range (72-308) versus 80 (13.5-187.8) mg/dL, p = 0.006) and higher Bedside Pediatric Early Warning Score (PEWS) 1-4 hours after initiation of HFNC (10.1 ± 0.8 versus 7.1 ± 0.4, p=0.001) was found in the failure group compared to the non-failure group. Among the 18 patients admitted to PICU, 14 (78%) needed intubation. Five (28 %) patients died during their PICU admission. None of the patients died outside the PICU.

Conclusion

In this study, one third of the pediatric cancer and HSCT patients receiving HFNC on the ward, eventually required PICU admission. A significant higher CRP and a higher Bedside PEWS 1-4 hours after initiation of HFNC were associated with HFNC treatment failure.

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