The Use of Modified High Flow Nasal Cannula (HFNC) In Preterm Infants With Neonatal Respiratory Distress Syndrome (NRSD) In Primary ICU Services
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Introduction: NRSD (Neonatal Respiratory Distress Syndrome) is one of the most frequent causes of newborns in intensive care (NICU). Several NICU centers are now using the High Flow Nasal Cannula (HFNC) in recent years. With the use of HFNC as a breath aid in preterm infants, HFNC had the same efficacy ratio as nasal Continuous Positive Airway Pressure (CPAP) (continuous or intermittent). Case Report: A three-day-old baby boy was admitted to anesthesia with respiratory failure due to grade II HMD with suspicion of congenital heart failure. The initial condition showed that a respiratory rate of 70-80x / minute, breathing of the nostrils and retractions in the intercostals and abdomen with 85% post ductal SpO2 with the help of a CPAP mask (Pinsp 10, Fio2 70%). There was a Ronchi sound in the right and left basal lungs, and hemodynamics obtained a pulse of 180-195x / minute, non-invasive blood pressure 95/34 mmHg (54), heart murmurs were not found. During day 1 - day three, the patient uses a CPAP mask until the patient vomits and being consulted to an Anesthesiologist. On day 3 - day seven, the patient uses HFNC; after day seven until day 10, the patient uses neonatal nasal canularis oxygen. Until day 10, the patient is still being treated at the NICU by administering oxygen 0.5 liters/minute with SpO2 ranging from 93-96% with stable conditions but still needing oxygen. Conclusion: The use of Modified High Flow Nasal Cannula (HFNC) in preterm infants with Neonatal Respiratory Distress Syndrome (NRSD) is more effective and efficient than CPAP. The use of HFNC was associated with a lower incidence of nasal trauma and pneumothorax than nasal CPAP.
Reuter S, Moser C, Baack M. Respiratory Distress in the Newborn. Pediatr Rev. 2014;35(10):417–29.
Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update. Neonatology. 2019;115(4):432–50.
Center UM. Respiratory Distress Syndrome (RDS). The Regents of the University of California; 2004. 79–84 p.
Alok K, BV B. Epidemiology of Respiratory Distress of Newborns. Indian J Pediatr. 1996;63(1):93–8.
Diamane ND, M G. Diagnostic and Management of Hyaline Membrane Disease. EC Paediatr. 2018;7(8):810–9.
Roberts CT, Hodgson KA. High Flow Treatment in Preterm Infants. Matern Heal Neonatol Perinatol. 2017;3(1).
Iskandar RATP, Kaban RK, Djer MM. Heated, Humidified High-Flow Nasal Cannula vs Nasal CPAP in Infants with Moderate Respiratory Distress. Paediatr Indones. 2019;59(6):331–9.
Wilkinson D, Andersen C, O'Donnell CP, Paoli AG De, Manley BJ. High flow nasal cannula for respiratory support in preterm infants. Cochrane Database Syst Rev. 2016;(2).
Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita ATN, Reddy UM, Saade GR, et al. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery. N Engl J Med. 2016;374(14):1311–20.
Berger R, Abele H, Bahlmann F, Bedei I, Doubek K, Felderhoff-Müser U, et al. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG. Geburtshilfe Frauenheilkd [Internet]. 2019;79(08):813–33. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/a-0903-2735
Suminto S. Peranan Surfaktan Eksogen pada Tatalaksana Respiratory Distress Syndrome Bayi Prematur. Cermin Dunia Kedokt. 2017;44(8):568–71.
Soll RF. A review on noninvasive ventilation: The Cochrane Systematic Reviews 2006. J Perinatol. 2007;27:S21–5.
Philippe F, Chantal L, Robert P, Emily R, Linda C, Rangasamy R. A Randomized Trial of Nasopharyngeal-Synchronized Intermittent Mandatory Ventilation Versus Nasopharyngeal Continuous Positive Airway Pressure in Very Low Birth Weight Infants After Extubation. J Perinatol. 1999;19(6):413–8.
Humphreys S, Schibler A. Nasal high-flow oxygen in pediatric anesthesia and airway management. Paediatr Anaesth. 2020;30(3):339–46.
Roehr CC, Yoder BA, Davis PG, Ives K. Evidence Support and Guidelines for Using Heated, Humidified, High-Flow Nasal Cannulae in Neonatology: Oxford Nasal High-Flow Therapy Meeting, 2015. Clin Perinatol. 2016;43(4):693–705.
Liew Z, Fenton AC, Harigopal S, Gopalakaje S, Brodlie M, O'Brien CJ. Physiological effects of high-flow nasal cannula therapy in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2020;105(1):F87–93.
Lorraine L, Robert W. Anesthetic Management of Adults with Congenital Heart Disease in Congenital Heart Disease in Pediatric and Adult Patients. Switzerland: Springer International Publishing; 2017. 365–398 p.
Porter ML, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002;65(4):599–606.
Hall RW, Shbarou RM. Drugs of Choice for Sedation and Analgesia in the Neonatal ICU. Clin Perinatol. 2009;36(2):215–26.
Hillman BA, Tabrizi MN, Gauda EB, Carson KA, Aucott SW. The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse's assessment of neonates. J Perinatol [Internet]. 2015;35(2):128–31. Available from: http://dx.doi.org/10.1038/jp.2014.154
Butler-O'Hara M, D'Angio CT, Hoey H, Stevens TP. An evidence-based catheter bundle alters central venous catheter strategy in newborn infants. J Pediatr [Internet]. 2012;160(6):972-977.e2. Available from: http://dx.doi.org/10.1016/j.jpeds.2011.12.004
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