INTRODUCTION
Asthma exacerbation is a frequent cause of pediatric intensive care unit (PICU) admission1-3. Its management includes pharmacology treatment and respiratory support with invasive mechanical ventilation as the last step. This modality, even though useful, may bring complications4 so other forms of respiratory support are discussed and debated as first-line approaches5-7. Nowadays, one of these options is high flow nasal cannula (HFNC).
The HFNC application has quickly spread in pediatrics due to its simplicity and comfort8-10. Its use of has been describe in neonatal wards11,12, emergency department13-15, hospital units11-17, transport18 and intensive care units19-21. In PICU the use of HNFC has been described with limited data about its usefulness or security in bronchiolitis22-24 or asthma20,21,25. It is a controversial approach because there is no strong evidence to recommend it. It’s a concern that HFNC could delay the start of other ventilatory strategies with proven efficacy like non-invasive mechanical ventilation (NIMV).
Consider this, in this prospective observational monocentric study, we describe and analyse the respiratory therapies applied to children with PICU admission because of asthma exacerbation. The primary objective was to analyse and describe the clinical and epidemiological characteristics of these cases. As a secondary objective, we evaluated the use of HFNC in these children and compared to other ways of respiratory support.