Treatment of Pediatric Patients With High-Flow Nasal Cannula and Considerations for Oral Feeding: A Review of the Literature.
Treatment of Pediatric Patients With High-Flow Nasal Cannula and Considerations for Oral Feeding: A Review of the Literature.
复制标题
DOI：
10.1044/2021_persp-21-00152
复制
发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
高流量鼻插管 (HFNC) 已成为儿科中越来越常见的无创呼吸支持手段，并用于重症监护病房内外患有呼吸窘迫的婴儿和儿童。尽管 HFNC 得到广泛使用，但关于最佳流速及其对发病率、死亡率和期望结果的影响的数据仍然很少。鉴于这些关键领域的信息匮乏，因此不存在开始经口喂养的指南也就不足为奇了。这篇综述文章将回顾 HFNC 的作用机制、其在特定人群和环境中的使用，以及最后对该治疗期间开始喂养的了解。在撰写本文时，文献不支持仅因 HFNC 而停止经口喂养的做法，但在缺乏临床试验安全性数据的情况下，临床医生在做出经口喂养决定时应谨慎行事并考虑患者的具体因素。需要良好对照的前瞻性临床试验来制定最佳实践临床指南和实现最佳结果。
High-Flow Nasal Cannula (HFNC) has become an increasingly common means of noninvasive respiratory support in pediatrics and is being used in infants and children with respiratory distress both inside and outside of the intensive care units. Despite the widespread use of HFNC, there remains a paucity of data on optimal flow rates and its impact on morbidity, mortality, and desired outcomes. Given the scarcity of information in these critical areas, it is not surprising that guidelines for initiation of oral feeding do not exist. This review article will review HFNC mechanisms of action, its use in specific populations and settings, and finally what is known about initiation of feeding during this therapy. The practice of withholding oral feeding solely, because of HFNC, is not supported in the literature at the time of this writing, but in the absence of safety data from clinical trials, clinicians should proceed with caution and consider patient-specific factors while making decisions about oral feeding. Well-controlled prospective clinical trials are needed for development of best practice clinical guidelines and attainment of optimal outcomes.