Conventional pediatric nasal cannula can safely deliver up to 4 lpm but are limited by cooling and drying of the airway. This leads to decreased airway patency, nasal mucosal injury, bleeding and possibly increase in coagulase negative staph infections.
HFNC delivers flow up to 40 lpm with 95-100% relative humidity at a controlled temperature. In infants, the initial flow rate is set between 2-4 lpm and can be increased to 8 lpm. Older children and can be started at 10 lpm and increased as high as 40 lpm. Oxygen is also adjustable.
Studies have shown improved comfort, respiratory rate and oxygenation compared to nasal CPAP.
References
Noninvasive Ventilation Techniques in the Emergency Department: Applications in Pediatric Patients. Pediatric Emergency Medicine Practice. Vol 6 No 6. June 2009.
Spentzas et al. Children with Respiratory Distress Treated with High-Flow Nasal Cannula. Journal of Intensive Care Medicine. Vol 24 No 5. September/October 2009.
