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Current practices and policies regarding the use of high-flow nasal cannula on general pediatric inpatient wards in Canada
Paediatrics & Child Health ( IF 1.9 ) Pub Date : 2021-05-20 , DOI: 10.1093/pch/pxab013
Chris Novak 1, 2, 3, 4 , Gemma Vomiero 3, 4 , Allan de Caen 1, 2 , Suzette Cooke 3, 4
Affiliation  

Objectives High-flow nasal cannula (HFNC) oxygen therapy has become a common treatment for respiratory conditions in children. To our knowledge, no study has described practice patterns for HFNC on pediatric inpatient wards in Canada. The aim of this study was to survey current practices and policies regarding the use of HFNC on the ward in children’s hospitals in Canada. Methods We conducted a web-based survey of Pediatric Hospital Medicine section chiefs in major tertiary care hospitals in Canada. The primary outcome was the proportion of hospitals that use HFNC on the general pediatric ward. Secondary outcomes included indications for HFNC, initial and maximum flow rates, maximum FiO2, method of nutrition delivery while on HFNC, level of nursing and respiratory therapist care required, criteria for pediatric intensive care unit transfer, and subjective successes and challenges of implementing a ward-based HFNC policy. Results The section chief survey response rate was 100% (15/15). Eight centres (53%) allowed the use of HFNC outside of an intensive care setting. Six centres initiated HFNC on the ward, while two centres only accepted patients after HFNC had been initiated in an intensive care setting. Other practices and policies varied considerably from centre to centre. Conclusion Our study reveals that approximately half of tertiary children’s hospitals in Canada currently use HFNC on the ward and utilize a range of practices and policies. Other centres are considering implementation. Further research is needed to inform best practices for HFNC therapy, support stewardship of health care resources, and promote safe patient care.

中文翻译:

加拿大普通儿科住院病房使用高流量鼻导管的现行做法和政策

目的 高流量鼻导管(HFNC)氧疗已成为儿童呼吸系统疾病的常见治疗方法。据我们所知,没有研究描述加拿大儿科住院病房中 HFNC 的实践模式。本研究的目的是调查加拿大儿童医院病房中使用 HFNC 的现行做法和政策。方法 我们对加拿大主要三级医院的儿科医院内科科长进行了网络调查。主要结果是在普通儿科病房使用 HFNC 的医院比例。次要结果包括 HFNC 的适应症、初始和最大流速、最大 FiO2、HFNC 时的营养输送方法、所需的护理和呼吸治疗师护理水平、儿科重症监护病房转移的标准、以及实施基于病房的 HFNC 政策的主观成功和挑战。结果科长调查回复率为100%(15/15)。八个中心 (53%) 允许在重症监护室之外使用 HFNC。六个中心在病房启动了 HFNC,而两个中心仅在重症监护室启动 HFNC 后才接受患者。其他做法和政策因中心而异。结论 我们的研究表明,加拿大大约一半的三级儿童医院目前在病房使用 HFNC,并采用一系列实践和政策。其他中心正在考虑实施。需要进一步的研究来为 HFNC 治疗的最佳实践提供信息,支持医疗保健资源的管理,并促进安全的患者护理。
更新日期:2021-05-20
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