Doğu Anadolu’da Yeni Kurulan Bir Çocuk Bakım Ünitesinde HFNC Deneyimi

Year 2024, Volume: 12 Issue: 3, 860 - 871, 21.10.2024

Muhammed Selçuk Sinanoğlu , Nagehan Aslan , Emrullah Arıkanoğlu , Nizami Avci , Uğur Saraç , Dinçer Yıldızdaş

https://doi.org/10.33715/inonusaglik.1532968

Abstract

Yüksek akışlı nazal kanül oksijen tedavisi (HFNC), akut solunum yetmezliği tedavisinde gün geçtikçe daha sık kullanılmaktadır. Solunum sıkıntısı olan hastalarda önemli etkileri mevcuttur. Çalışmamızda, yeni kurulan çocuk yoğun bakım ünitemizdeki HFNC deneyimlerimizi paylaşmayı planladık. Bu retrospektif çalışmaya 1 ay 18 yaş arası tüm çocuklar dahil edildi. Toplam 126 hastanın 74’ü (%58,7) erkekti. Ortalama yaş 59,8±66,7 ay idi. Hastaların tedavi öncesi, tedavi sonrası 1.saat, 8.saat ve 24.saatteki kalp atım sayıları, oksijen saturasyonları ve solunum sayıları arasında istatistiksel olarak anlamlı farklılık görüldü. Hastaların 16’sı (%12,7) HFNC başarısızlığı sonucu entübe edildi. Entübe edilenlerin başvurudaki SpO2/FiO2 oranı entübe edilmeyenlerin değerinden anlamlı şekilde düşük bulundu (p<0,001). Entübe edilen hastaların başvuru HFNC FiO2 değeri, yoğun bakım yatış süresi ve hastanede yatma süresi entübe edilmeyenlerin değerlerinden anlamlı şekilde yüksek saptandı (p<0,001). Tedavi başarısızlığına ve olası komplikasyonlara dikkat edilerek HFNC’nin çocuk yoğun bakım ünitelerinde çeşitli akut solunum sıkıntısı etiyolojilerinde başarılı bir şekilde kullanılabileceğini düşünüyoruz.

Keywords

Çocuk, Yoğun bakım, Yüksek akışlı nazal kanül oksijen tedavisi

HFNC EXPERIENCE IN A NEWLY ESTABLISHED PEDIATRIC INTENSIVE CARE UNIT IN EASTERN ANATOLIA

Abstract

High-flow nasal cannula oxygen therapy (HFNC) is increasingly used in the treatment of acute respiratory failure. It has important effects in patients with respiratory distress. In our study, we planned to share our HFNC experiences in our newly established pediatric intensive care unit. All children between the ages of 1 month and 18 years were included in this retrospective study. Of the 126 patients, 74 (58.7%) were male. The mean age was 59.8±66.7 months. Significant differences were observed between the heart rate, oxygen saturation and respiratory rate of the patients before treatment and at the 1st, 8th and 24th hours after treatment. 16 (12.7%) of the patients were intubated due to HFNC failure. The SpO2/FiO2 ratio at presentation of those who were intubated was found to be significantly lower than the value of those who were not intubated (p<0.001). The admission HFNC FiO2 value, intensive care unit stay and hospital stay of intubated patients were found to be significantly higher than the values of non-intubated patients (p<0.001). We believe that HFNC can be used successfully in pediatric intensive care units for various etiologies of acute respiratory distress, paying attention to treatment failure and possible complications.

Keywords

High flow nasal cannula oxygen therapy, Intensive care, Pediatric

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