![]() ![]() SpO 2 is persistently less than 90% (PaO2 less than 80mmHg) in patients without cyanotic heart disease.Supplemental Oxygen therapy should be commenced for patients on HFNP who display hypoxaemia The addition of supplemental oxygen requires approval from ENT or PICU Consultant. ![]() When HFNP therapy is commenced to provide respiratory support for children with non-respiratory issues, supplemental oxygen should be used cautiously with a FiO 2 not greater than 0.3 In children with cyanotic congenital heart disease and balanced circulation, HFNP therapy is generally used with an FiO 2 of 0.21 (air) or a low increased fraction of oxygen (≤30%) The addition of supplemental oxygen requires approval from Cardiac or PICU Consultant In children with clinical signs of upper airway obstruction (noisy breathing, tracheal tug, subcostal retractions, absence of tachypnoea) or potential obstruction e.g., post-op Ts & As on HFNP therapy should only receive FiO 2 0.21 (air). Maintaining nasal cilia function due to the high flow rate Humidification is necessary to avoid drying of respiratory secretions and for The prescribed rate over a few minutes, or as tolerated. Respiratory distress associated with respiratory illness, hypoxaemia (SpO 212Kg: 2 L/kg/minuteįor the first 12kg + 0.5L/kg/minute for each kg thereafter (max flow 50 L/min) Ventilation - Perfusion (VQ) mismatch: An imbalance between alveolar ventilation and pulmonary capillary blood flow.Tidal Volume: The amount of gas that moves in, and out, of the lungs with each breath, measured in millilitres (6-10 ml/kg).Peak Inspiratory Flow Rate (PIFR): The fastest flow rate of air during inspiration, measured in litres per second.Low flow: Low flow systems are specific devices that do not provide the patient's entire ventilatory requirements, room air is entrained with the oxygen, diluting the FiO 2.Hypoxia: Low oxygen level at the tissues.Hypoxaemia: Low arterial oxygen tension (in the blood.).Hypercapnea: Increased amounts of carbon dioxide in the blood.The amount of water vapour that a gas can carry increases with temperature. Humidification is the addition of heat and moisture to a gas.Where the total flow delivered to the patient meets or exceeds their Peak Inspiratory Flow Rate the FiO 2 delivered to the patient will be accurate. High flow: High flow systems are specific devices that deliver the patient's entire ventilatory demand, meeting, or exceeding the patients Peak Inspiratory Flow Rate (PIFR), thereby providing an accurate FiO 2.SpO 2: Arterial oxygen saturation measured via pulse oximetry.SaO 2: Arterial oxygen saturation measured from blood specimen.It is used to assess the adequacy of oxygenation. PaO 2: The partial pressure of oxygen in arterial blood.It is used to assess the adequacy of ventilation. PaCO 2: The partial pressure of CO 2 in arterial blood.FiO 2: Fraction of inspired oxygen (%).CPAP: Continuous Positive Airway Pressure.This guideline does not refer to the management of HFNP in the neonatal The aim of this guideline is to describe the indications and procedure for the use of High Flow Nasal Prong (HFNP) therapy within paediatrics. PPE including P2/N95 masks should be discarded following an aerosol generating procedure or discarded and replaced if contaminated with blood or body fluids. ![]() The patient should be transferred to a negative pressure room as soon as possible. Airborne precautions should be maintained for 30minutes after an AGP has been performed. If a negative pressure room is unavailable, AGPs may be performed in a single room without negative pressure ventilation with the door closed. Eyewear, face shield) Long-sleeved gown Gloves (non-sterile). When HFNP therapy is required for a SCOVID or COVID patient, this should be carried out in a negative pressure room using Airborne Precautions which include personal protective equipment (PPE): P2 respirator (N95 mask) Eye protection (e.g. Please Note: HFNP therapy is an aerosol generating procedure (AGP), a patient’s clinical requirement for HFNP should be balanced against the risk of aerosolization. The high flows may also affect pulmonary and systemic circulation which is an important consideration when applying HFNP therapy to children with cardiac disease. The high flows and humidification improve functional residual capacity and mucocililary clearance of secretions thereby reducing work of breathing. At high flows of 2 litres per kilogram per minute, using appropriate nasal prongs, a positive distending pressure may be achieved. HFNP may act as a bridge between low flow oxygen therapies and CPAP, reducing the need for CPAP/intubation. Humidified high flow nasal prong (HFNP) therapy is a form of non-invasive respiratory support. ![]()
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