Comparative Evaluation of High-flow Nasal Cannula Oxygenation Vs Nasal Intermittent Ventilation in Postoperative Paediatric Patients Operated for Acyanotic Congenital Cardiac Defects

Overview

Journal Med J Armed Forces India

Specialty General Medicine

Date 2022 Oct 21

PMID 36267502

Authors

Alok Kumar

Saajan Joshi

Nikhil Tiwari

Vivek Kumar

H R Ramamurthy

Gaurav Kumar

Vipul Sharma

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to compare high-flow nasal cannula (HFNC) oxygenation vs nasal intermittent ventilation (NIV) oxygenation for respiratory care after extubation in postoperative paediatric cardiac patients.

Methods: This study was a randomised controlled trial. One hundred twenty-one paediatric patients with acyanotic congenital heart disease undergoing corrective cardiac surgery on cardiopulmonary bypass were included in the study. Patients were randomised to receive either HFNC (AIRVO) or NIV (RAM Cannula) postextubation. Arterial blood gas was analysed at different time points perioperatively.

Results: Patients in both the groups were matched with respect to diagnosis and demographic profiles. Baseline hemodynamic and respiratory parameters were also similar in both the groups. Patients in HFNC/AIRVO group did not show improved carbon dioxide (CO) washout but showed improved pO and pO/FiO ratio immediate postextubation. Reintubation rate and other intensive care unit (ICU) complications were similar in both the groups.

Conclusion: Postcardiopulmonary bypass respiratory complications in paediatric patients with congenital acyanotic heart disease can be minimised with newer oxygen therapy devices such as AIRVO (HFNC) or RAM cannula (NIV). In comparison between these two, AIRVO did not show improved CO washout over RAM cannula; however, it did provide better oxygenation as measured by pO in arterial blood and pO/FiO ratio immediate postextubation. Also, long-term results such as duration of mechanical ventilation and ICU stay were not affected by the choice of device.

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