Comparative Evaluation of High-Flow Nasal Cannula and Conventional O2 Therapy in Pediatric Cardiac Surgical Patients

A randomized, controlled trial was conducted to compare the effectiveness of high-flow nasal cannula (HFNC) and conventional O2 therapy (OT) in pediatric cardiac surgical patients under 18 months of age. The primary objective was to evaluate HFNC's ability to improve PaCO2 elimination within the first 48 hours post-extubation. Patients were randomly assigned to either OT or HFNC groups at the beginning of ventilation weaning. Arterial blood samples were collected before and after extubation at specified time points to measure PaCO2, PaO2, and PaO2/FiO2 ratios, among other outcomes.

Results indicated that while there was no significant difference in PaCO2 levels between the HFNC and OT groups, PaO2 and PaO2/FiO2 ratios were significantly improved in the HFNC group. The rate of reintubation did not differ between the groups, but the need for noninvasive respiratory support was 15% in the OT group and nonexistent in the HFNC group. This suggests that HFNC may offer benefits in terms of oxygenation and reducing the need for additional respiratory support in pediatric cardiac surgical patients post-extubation.