Clin Exp Pediatr > Accepted Articles
DOI:    [Accepted]
Published online May 24, 2021.
Modified high-flow nasal cannula for children with respiratory distress
Sarocha Itdhiamornkulchai1, Aroonwan Preutthipan2, Jarin Vaewpanich1, Nattachai Anantasit1 
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Nattachai Anantasit, Email:
Received: 14 August 2020   • Revised: 24 April 2021   • Accepted: 13 May 2021
High-flow nasal cannula (HFNC) is a non-invasive respiratory support that provides the optimum flow of an air–oxygen mixture. Several studies demonstrated its usefulness and good safety profile for treating pediatric respiratory distress patients. However, the cost of the commercial HFNC is high; therefore, the modified high-flow nasal cannula was developed.
This study aimed to compare the effectiveness, safety, and nurses’ satisfaction of the modified system versus the standard commercial HFNC.
This prospective comparative study was performed in a tertiary care hospital. We recruited children aged 1 month to 5 years who developed acute respiratory distress and were admitted to the pediatric intensive care unit. Patients were assigned to two groups (modified vs commercial). The effectiveness and safety assessments included vital signs, respiratory scores, intubation rate, adverse events, and nurses’ satisfaction.
A total of 74 patients were treated with HFNC. Thirty-nine patients were assigned to the modified group, while the remaining 35 patients were in the commercial group. Intubation rate and adverse events did not differ significantly between the two groups. However, the commercial group had higher nurses’ satisfaction scores than the modified group.
Our findings suggest that our low-cost modified HFNC could be a useful respiratory support option for younger children with acute respiratory distress, especially in hospital settings with financial constraints.
Key Words: High-flow nasal cannula, Non-invasive respiratory support, Respiratory distress, Respiratory failure

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