Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies

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dc.contributor.advisorMorrow, Brenda Men_ZA
dc.contributor.advisorMcCulloch, Mignonen_ZA
dc.contributor.authorBrowde, Kateen_ZA
dc.date.accessioned2017-09-14T12:23:35Z
dc.date.available2017-09-14T12:23:35Z
dc.date.issued2017en_ZA
dc.description.abstractAim: Noninvasive Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) are non-invasive ventilation (NIV) modalities appropriate for children in developing countries. There is minimal literature describing nCPAP and HFNC use in children with respiratory compromise secondary to non-pulmonary disease. This study aimed to describe the characteristics and outcomes of all children without primary lung pathology, who received nCPAP and HFNC during their admission to Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods: This was a prospective observational study of routinely collected data, between August 2015 and January 2016. Primary and secondary outcome measures were NIV failure (progression to intubation and invasive ventilation) and Paediatric Intensive Care Unit (PICU) admission respectively. Comparative statistics were conducted using Mann-Whitney U tests. Data significantly associated with the primary and secondary outcomes on univariate analysis were entered into backward stepwise logistic regression models to determine independent predictive factors. Results: There were 31 cases of nCPAP and one case of HFNC use in 31 patients (median (IQR) age 3.5 (1.8 – 7.6) months. The majority (n=23; 71.9%) presented with primary diarrhoeal disease. There were two deaths (6.5%), 17 (53.1%) Paediatric Intensive Care (PICU) admissions, and five (15.6%) cases received invasive ventilation (NIV failure). Median (IQR) duration of hospital stay was 11.50 (6.0 – 17.5) days. Patients who failed NIV had lower admission SaO2 than those without treatment failure (95 (95-99)% vs 100 (100-100)%; p = 0.03). On multiple logistic regression, lower temperature (OR 0.19; 95% CI 0.05 – 0.78; p = 0.02) and receiving inotropes in the emergency setting, (OR 23.05; 95% CI 1.64 – 325.06; p = 0.02) were independently associated with PICU admission. Conclusions: nCPAP is used clinically for the management of children with respiratory compromise secondary to non-pulmonary illnesses, particularly diarrhoeal disease. Larger controlled clinical studies are needed to determine the effectiveness and utility of nCPAP in this population. HFNC was not commonly used, and this modality requires further investigation in this population.en_ZA
dc.identifier.apacitationBrowde, K. (2017). <i>Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/25195en_ZA
dc.identifier.chicagocitationBrowde, Kate. <i>"Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2017. http://hdl.handle.net/11427/25195en_ZA
dc.identifier.citationBrowde, K. 2017. Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Browde, Kate AB - Aim: Noninvasive Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) are non-invasive ventilation (NIV) modalities appropriate for children in developing countries. There is minimal literature describing nCPAP and HFNC use in children with respiratory compromise secondary to non-pulmonary disease. This study aimed to describe the characteristics and outcomes of all children without primary lung pathology, who received nCPAP and HFNC during their admission to Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods: This was a prospective observational study of routinely collected data, between August 2015 and January 2016. Primary and secondary outcome measures were NIV failure (progression to intubation and invasive ventilation) and Paediatric Intensive Care Unit (PICU) admission respectively. Comparative statistics were conducted using Mann-Whitney U tests. Data significantly associated with the primary and secondary outcomes on univariate analysis were entered into backward stepwise logistic regression models to determine independent predictive factors. Results: There were 31 cases of nCPAP and one case of HFNC use in 31 patients (median (IQR) age 3.5 (1.8 – 7.6) months. The majority (n=23; 71.9%) presented with primary diarrhoeal disease. There were two deaths (6.5%), 17 (53.1%) Paediatric Intensive Care (PICU) admissions, and five (15.6%) cases received invasive ventilation (NIV failure). Median (IQR) duration of hospital stay was 11.50 (6.0 – 17.5) days. Patients who failed NIV had lower admission SaO2 than those without treatment failure (95 (95-99)% vs 100 (100-100)%; p = 0.03). On multiple logistic regression, lower temperature (OR 0.19; 95% CI 0.05 – 0.78; p = 0.02) and receiving inotropes in the emergency setting, (OR 23.05; 95% CI 1.64 – 325.06; p = 0.02) were independently associated with PICU admission. Conclusions: nCPAP is used clinically for the management of children with respiratory compromise secondary to non-pulmonary illnesses, particularly diarrhoeal disease. Larger controlled clinical studies are needed to determine the effectiveness and utility of nCPAP in this population. HFNC was not commonly used, and this modality requires further investigation in this population. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies TI - Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies UR - http://hdl.handle.net/11427/25195 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/25195
dc.identifier.vancouvercitationBrowde K. Indication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologies. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/25195en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPaediatricsen_ZA
dc.titleIndication for and outcomes of continuous Positive Airways Pressure (CPAP) and High Flow Nasal Cannula oxygen therapy (HFNC) in children admitted to Red Cross War Memorial's Hospital (RCWMCH) excluding those with primary respiratory aetiologiesen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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