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Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies
Aim: Noninvasive Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) are non-invasive ventilation (NIV) modalities appropriate for children in developing countries. There is minimal literature describing nCPAP and HFNC use in children with respiratory compro...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2017
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| _version_ | 1867613208904204288 |
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| access_status_str | Open Access |
| author | Browde, Kate |
| author2 | Morrow, Brenda M |
| author_browse | Browde, Kate Morrow, Brenda M |
| author_facet | Morrow, Brenda M Browde, Kate |
| author_sort | Browde, Kate |
| collection | Thesis |
| description | Aim: Noninvasive Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) are non-invasive ventilation (NIV) modalities appropriate for children in developing countries. There is minimal literature describing nCPAP and HFNC use in children with respiratory compromise secondary to non-pulmonary disease. This study aimed to describe the characteristics and outcomes of all children without primary lung pathology, who received nCPAP and HFNC during their admission to Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods: This was a prospective observational study of routinely collected data, between August 2015 and January 2016. Primary and secondary outcome measures were NIV failure (progression to intubation and invasive ventilation) and Paediatric Intensive Care Unit (PICU) admission respectively. Comparative statistics were conducted using Mann-Whitney U tests. Data significantly associated with the primary and secondary outcomes on univariate analysis were entered into backward stepwise logistic regression models to determine independent predictive factors. Results: There were 31 cases of nCPAP and one case of HFNC use in 31 patients (median (IQR) age 3.5 (1.8 – 7.6) months. The majority (n=23; 71.9%) presented with primary diarrhoeal disease. There were two deaths (6.5%), 17 (53.1%) Paediatric Intensive Care (PICU) admissions, and five (15.6%) cases received invasive ventilation (NIV failure). Median (IQR) duration of hospital stay was 11.50 (6.0 – 17.5) days. Patients who failed NIV had lower admission SaO2 than those without treatment failure (95 (95-99)% vs 100 (100-100)%; p = 0.03). On multiple logistic regression, lower temperature (OR 0.19; 95% CI 0.05 – 0.78; p = 0.02) and receiving inotropes in the emergency setting, (OR 23.05; 95% CI 1.64 – 325.06; p = 0.02) were independently associated with PICU admission. Conclusions: nCPAP is used clinically for the management of children with respiratory compromise secondary to non-pulmonary illnesses, particularly diarrhoeal disease. Larger controlled clinical studies are needed to determine the effectiveness and utility of nCPAP in this population. HFNC was not commonly used, and this modality requires further investigation in this population. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/25195 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:29.432Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/25195 Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies Browde, Kate Morrow, Brenda M McCulloch, Mignon Paediatrics Aim: Noninvasive Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) are non-invasive ventilation (NIV) modalities appropriate for children in developing countries. There is minimal literature describing nCPAP and HFNC use in children with respiratory compromise secondary to non-pulmonary disease. This study aimed to describe the characteristics and outcomes of all children without primary lung pathology, who received nCPAP and HFNC during their admission to Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods: This was a prospective observational study of routinely collected data, between August 2015 and January 2016. Primary and secondary outcome measures were NIV failure (progression to intubation and invasive ventilation) and Paediatric Intensive Care Unit (PICU) admission respectively. Comparative statistics were conducted using Mann-Whitney U tests. Data significantly associated with the primary and secondary outcomes on univariate analysis were entered into backward stepwise logistic regression models to determine independent predictive factors. Results: There were 31 cases of nCPAP and one case of HFNC use in 31 patients (median (IQR) age 3.5 (1.8 – 7.6) months. The majority (n=23; 71.9%) presented with primary diarrhoeal disease. There were two deaths (6.5%), 17 (53.1%) Paediatric Intensive Care (PICU) admissions, and five (15.6%) cases received invasive ventilation (NIV failure). Median (IQR) duration of hospital stay was 11.50 (6.0 – 17.5) days. Patients who failed NIV had lower admission SaO2 than those without treatment failure (95 (95-99)% vs 100 (100-100)%; p = 0.03). On multiple logistic regression, lower temperature (OR 0.19; 95% CI 0.05 – 0.78; p = 0.02) and receiving inotropes in the emergency setting, (OR 23.05; 95% CI 1.64 – 325.06; p = 0.02) were independently associated with PICU admission. Conclusions: nCPAP is used clinically for the management of children with respiratory compromise secondary to non-pulmonary illnesses, particularly diarrhoeal disease. Larger controlled clinical studies are needed to determine the effectiveness and utility of nCPAP in this population. HFNC was not commonly used, and this modality requires further investigation in this population. 2017-09-14T12:23:35Z 2017-09-14T12:23:35Z 2017 Master Thesis Masters MMed http://hdl.handle.net/11427/25195 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town |
| spellingShingle | Paediatrics Browde, Kate Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| thesis_degree_str | Master's |
| title | Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| title_full | Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| title_fullStr | Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| title_full_unstemmed | Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| title_short | Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies |
| title_sort | indication for and outcomes of continuous positive airways pressure cpap and high flow nasal cannula oxygen therapy hfnc in children admitted to red cross war memorial s hospital rcwmch excluding those with primary respiratory aetiologies |
| topic | Paediatrics |
| url | http://hdl.handle.net/11427/25195 |
| work_keys_str_mv | AT browdekate indicationforandoutcomesofcontinuouspositiveairwayspressurecpapandhighflownasalcannulaoxygentherapyhfncinchildrenadmittedtoredcrosswarmemorialshospitalrcwmchexcludingthosewithprimaryrespiratoryaetiologies |