High Flow Nasal Cannula

Heated, humidified high-flow nasal cannula (HHHFNC) therapy provides warmed, humidified oxygen to infants and children in respiratory distress at flow rates that deliver higher oxygen concentrations and some positive airway pressure compared with standard low-flow therapy. Increased use and experience is informing practice and establishing the benefits of HHHFNC use in a variety of clinical conditions. The focus of this practice point is to describe best practices for HHHFNC in (non-neonatal) paediatric patients with moderate-to-severe respiratory distress and to offer a safe, practical approach to oxygen delivery and support.

The aim of this guideline is to ensure safe and effective use of Nasal High Flow (NHF) therapy for children with acute respiratory illness through: Appropriate placement in inpatient areas with trained staff. Support for decision making in relation to initiation, continuation and weaning of therapy and escalation of concerns.

This guideline has been developed to provide an evidence-based clinical framework for the management of infants (012 months) with bronchiolitis treated in Australasian emergency departments (EDs) or general paediatric wards. Application of these guidelines for children over 12 months may be relevant but there is less diagnostic certainty in the 1224 month age group. (All references to age within this guideline refer to chronological age unless stated otherwise).

This Guideline presents the current best evidence for Humidified High Flow Nasal Cannula Oxygen. Its purpose is to inform practice for clinicians in Metropolitan Level 4 Paediatric Units and Metropolitan Emergency Departments caring for infants and children who may benefit from Humidified High Flow Nasal Cannula Oxygen therapy.