Abstract：
OBJECTIVE: To describe the high-flow nasal cannula (HFNC) indications in the Spanish pediatric critical care units (PICUs).
METHODS: Descriptive cross-sectional observational study.
METHODS: Electronic survey among members of the Spanish Society of Pediatric Intensive Care (SECIP). It was sent weekly from April 10, 2023, to May 21, 2023.
METHODS: All SECIP members.
METHODS: None.
METHODS: The questions focused on workplace, years of experience, use or non-use of HFNC, justification and expectations regarding its application, starting point within each center, clinical criteria for indication, existence of clinical guidelines, evaluation during its use, and criteria and mode of withdrawal.
RESULTS: Two hundred and two participants, 176 were from Spain. Of these, 87/176 had over ten years of experience. One hundred sixty two use HFNC and 66/162 have HFNC clinical guidelines. Acute bronchiolitis (138/162) and respiratory assistance after extubation (106/56) are the two main indications. For 62/162 HFNC may reduce therapeutic escalation. Neuromuscular diseases (105/162) and anatomical airway diseases (135/162) are the two main contraindications. The reasons to do not use HFNC were the absence of evidence about it effectiveness (8/14) and its inadequate cost/effectiveness balance (8/14).
CONCLUSIONS: A majority of Spanish pediatric intensivists use HFNC. Its application and withdrawal appears to be primarily based on clinical experience. Besides, those who use HFNC are aware of its limitations and the lack of evidence in some cases. It is necessary to develop single-center and multicenter studies to elucidate the effectiveness of this therapy in the context of critically ill children.
METHODS: Descriptive cross-sectional observational study.
METHODS: Electronic survey among members of the Spanish Society of Pediatric Intensive Care (SECIP). It was sent weekly from April 10, 2023, to May 21, 2023.
METHODS: All SECIP members.
METHODS: None.
METHODS: The questions focused on workplace, years of experience, use or non-use of HFNC, justification and expectations regarding its application, starting point within each center, clinical criteria for indication, existence of clinical guidelines, evaluation during its use, and criteria and mode of withdrawal.
RESULTS: Two hundred and two participants, 176 were from Spain. Of these, 87/176 had over ten years of experience. One hundred sixty two use HFNC and 66/162 have HFNC clinical guidelines. Acute bronchiolitis (138/162) and respiratory assistance after extubation (106/56) are the two main indications. For 62/162 HFNC may reduce therapeutic escalation. Neuromuscular diseases (105/162) and anatomical airway diseases (135/162) are the two main contraindications. The reasons to do not use HFNC were the absence of evidence about it effectiveness (8/14) and its inadequate cost/effectiveness balance (8/14).
CONCLUSIONS: A majority of Spanish pediatric intensivists use HFNC. Its application and withdrawal appears to be primarily based on clinical experience. Besides, those who use HFNC are aware of its limitations and the lack of evidence in some cases. It is necessary to develop single-center and multicenter studies to elucidate the effectiveness of this therapy in the context of critically ill children.
摘要：
目的：描述西班牙儿科重症监护病房（PICU）的高流量鼻插管（HFNC）适应症。
方法：描述性横断面观察研究。
方法：西班牙儿科重症监护协会（SECIP）成员的电子调查。它是从2023年4月10日至2023年5月21日每周发送一次。
方法：所有SECIP成员。
方法：无。
方法：问题集中在工作场所，多年的经验,使用或不使用HFNC，关于其应用的理由和期望，每个中心的起点，适应症的临床标准，临床指南的存在，在使用过程中进行评估，以及退出的标准和方式。
结果：200名参与者，176人来自西班牙。其中,87/176有十多年的经验。一百六十二使用HFNC和66/162有HFNC临床指南。急性细支气管炎（138/162）和拔管后呼吸辅助（106/56）是两个主要适应症。对于62/162，HFNC可以减少治疗升级。神经肌肉疾病（105/162）和解剖学气道疾病（135/162）是两个主要禁忌症。不使用HFNC的原因是缺乏关于其有效性的证据（8/14）及其成本/有效性平衡不足（8/14）。
结论：大多数西班牙儿科重症医师使用HFNC。其应用和退出似乎主要基于临床经验。此外,使用HFNC的人意识到其局限性，并且在某些情况下缺乏证据。有必要开展单中心和多中心研究，以阐明这种疗法在危重病儿童中的有效性。
方法：描述性横断面观察研究。
方法：西班牙儿科重症监护协会（SECIP）成员的电子调查。它是从2023年4月10日至2023年5月21日每周发送一次。
方法：所有SECIP成员。
方法：无。
方法：问题集中在工作场所，多年的经验,使用或不使用HFNC，关于其应用的理由和期望，每个中心的起点，适应症的临床标准，临床指南的存在，在使用过程中进行评估，以及退出的标准和方式。
结果：200名参与者，176人来自西班牙。其中,87/176有十多年的经验。一百六十二使用HFNC和66/162有HFNC临床指南。急性细支气管炎（138/162）和拔管后呼吸辅助（106/56）是两个主要适应症。对于62/162，HFNC可以减少治疗升级。神经肌肉疾病（105/162）和解剖学气道疾病（135/162）是两个主要禁忌症。不使用HFNC的原因是缺乏关于其有效性的证据（8/14）及其成本/有效性平衡不足（8/14）。
结论：大多数西班牙儿科重症医师使用HFNC。其应用和退出似乎主要基于临床经验。此外,使用HFNC的人意识到其局限性，并且在某些情况下缺乏证据。有必要开展单中心和多中心研究，以阐明这种疗法在危重病儿童中的有效性。
