Effectiveness of Heated Humidified High-Flow Nasal Cannula on Respiratory Rate and Oxygen Saturation in Children with Respiratory Distress: A Comparison Across Age Groups at Phukhieo Chaloem Phrakiat Hospital, Chaiyaphum Province.
Keywords:
HHHFNC, Dyspnea, Pediatric patientsAbstract
Respiratory distress is a leading cause of pediatric intensive care admission, and response to heated humidified high-flow nasal cannula (HHHFNC) therapy tends to vary by age. This study aimed to compare respiratory rate and oxygen saturation before and after HHHFNC treatment within each age group, and to compare duration of HHHFNC use across age groups, among pediatric patients with respiratory distress at Phu Khieo Chalermprakiat Hospital, Chaiyaphum Province, Thailand. This retrospective analytical cross-sectional study included 102 pediatric patients divided into three age groups of 34 each, with medical records from October 2022 to September 2024 analyzed using Generalized Estimating Equations (GEE) and the Kruskal-Wallis test.
Respiratory rate decreased and oxygen saturation increased significantly across all age groups (p<0.001), and the magnitude of the respiratory rate decrease differed significantly between age groups (p=0.0006). Infants showed a reduction 6.56 breaths/min greater than that of children aged ≥61 months (95% CI 2.78, 10.34), and children aged 13-60 months showed a reduction 4.50 breaths/min greater (95% CI 1.34, 7.66). In contrast, the magnitude of oxygen saturation improvement did not differ significantly between age groups (p=0.178), nor did duration of HHHFNC use (p=0.638).
This study confirms the effectiveness of HHHFNC across all pediatric age groups and provides clear statistical evidence that the magnitude of respiratory rate response differs by age, with infants responding best. Respiratory rate should therefore be monitored especially closely in infants, while oxygen saturation and treatment duration can follow a common approach across age groups, as no significant age-related difference was demonstrated for these outcomes.
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