Cardiopulmonary outcomes following high flow nasal cannula in pediatric population: A systematic review.

Background: The high-flow nasal cannula (HFNC) has received much attention in various clinical settings and has been approved recently for application in pediatric care.

Objectives: To determine whether HFNC use improves cardiopulmonary outcomes in pediatric patients with the cardiac disease more effectively than alternative oxygen therapies.

Methods: Systematic review was performed using PubMed, Scopus, and Web of Science databases. Randomized controlled trials comparing HFNC with alternative oxygen therapies and observational studies that solely reported on the use of HFNC in the pediatric population were included between 2012 and 2022.

Results: Nine studies with approximately 656 patients were reported in this review. HFNC significantly increased systemic oxygen saturation across all literature investigating this parameter. Other notable outcomes in HFNC patients included normalizing heart rate, partial blood pressure, and PaO/FiO ratio. However, some studies reported a complication rate concurrent with traditional oxygen therapies, and a suggested HFNC failure rate of 50% was observed.

Conclusions: Compared with traditional oxygen therapies, HFNC can reduce anatomical dead space and normalize systemic oxygen saturation, PaO2/FiO2 ratio, heart rate, and partial blood pressure. We advocate using HFNC therapy in children with cardiac diseases as the currently available evidence supports HFNC use over other oxygenation treatments in the pediatric population.