Indications and outcomes of pediatric high flow nasal cannula use in the home setting
Bibliographic record
Abstract
Abstract Objective To describe the patient characteristics, indications, and clinical outcomes of home high flow nasal cannula (HFNC) among pediatric patients. To evaluate secular trends in home HFNC initiation between 2013 and 2022. Methods A retrospective review of all children on home HFNC between 2013 and 2023 was conducted at a tertiary care pediatric hospital in Ontario, Canada. Descriptive statistics were used to summarize results and identify indications for home HFNC initiation. Mann‐Kendall Trend test was used to assess trends in HHF initiation between 2013 and 2022. Results A total of 35 patients, ages 6 months–14 years old, were started on home HFNC between 2013 and 2023. HFNC initiation increased over time, from 0 patients in 2013–2016 to nine patients per year in 2021 and 2022 ( p < .001). Home HFNC was almost exclusively prescribed for children with multisystem conditions, 77% with an underlying genetic disorder, and 77% with prior home feeding tube use. Most children (83%) had multiple indications leading to initiation of home HFNC. The main indications included the following: (i) upper airway obstruction (66%), (ii) clearance of retained CO 2 (57%), (iii) increased work of breathing without sleep‐disordered breathing (29%), (iv) promotion of secretion clearance/plastic bronchitis (29%), and (v) palliative care (14%). In addition, 37% did not tolerate a previous trial of Continuous/Bi‐Level Positive Airway Pressure. Complications were rare, with only two children developing epistaxis requiring an emergency department visit and 4 children requiring escalation in home respiratory support to CPAP or BiPAP. Conclusion HFNC is increasingly being initiated among children in the home setting for varied indications. Preliminary data suggests few complications and a need for escalation of therapy with home HFNC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".