High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation is necessary to prevent late discovery of respiratory failure and of lack of experience. Paediatric Early Warning Scores (PEWS, figure 1) are used to detect and monitor severely sick patients. In our hospital we use the PEWS as developed by Parshuram with the addition of the body temperature 1,2

High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation is necessary to prevent late discovery of respiratory failure and of lack of experience. Paediatric Early Warning Scores (PEWS, figure 1) are used to detect and monitor severely sick patients. In our hospital we use the PEWS as developed by Parshuram with the addition of the body temperature 1,2

Respiratory morbidity at follow up of small for gestational age infants born very prematurely

Background: To determine whether small for gestational age (SGA) infants, born very prematurely had increased respiratory morbidity in the neonatal period and at follow up.Methods: Data were examined from infants entered into the United Kingdom Oscillation Study (UKOS). 174 of 797 infants who were born at less than 29 weeks of gestational age, were SGA. Overall, 92% were exposed to antenatal corticosteroids and 97% received surfactant and follow up data at 22-28 months were available for 367 infants.Results: After adjustment for gestational age and sex, SGA infants had higher rates of supplementary oxygen dependency at 36 weeks postmenstrual age (OR: 3.23; 95% CI 2.03, 5.13), pulmonary haemorrhage (3.07; 1.82, 5.18), death (3.32; 2.13, 5.17) and postnatal corticosteroid requirement (2.09;1.35,3.23). After adjustment for infant and respiratory morbidity risk factors, a lower mean birth weight z- score was associated with a higher prevalence of respiratory admissions (OR 1.40; 1.03, 1.88 for one standard deviation change in z score), cough (1.28; 1.00, 1.65) and use of chest medicines (1.32; 1.01, 1.73).Conclusion: Small for gestational age, very prematurely born infants, despite routine use of antenatal corticosteroids and postnatal surfactant, had increased respiratory morbidity at follow up, which was not due to poor neonatal outcome