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.