High-flow nasal cannula usage outside of intensive care associated with longer hospital stays, higher costs

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Excessive-flow nasal cannula (HFNC) therapy for sufferers with gentle to reasonable bronchiolitis could also be related to longer hospital stays and better value of care, in line with a research led by Le Bonheur Hospitalist Jeffrey C. Winer, MD, MA, MSHS, and revealed within the journal Hospital Pediatrics.

“Traditionally, the connection between HFNC utilization exterior of the intensive care unit and outcomes together with hospital size of keep and value is unclear. Our research sought to see if HFNC itself could also be partially liable for these outcomes,” mentioned Winer.

HFNC is a therapy that delivers oxygen to a affected person at a excessive fee, lowering the work of respiratory. It’s extensively used for treating bronchiolitis, a decrease respiratory tract an infection and a number one explanation for emergency room visits for kids youthful than 2.

Latest research on HFNC have proven variable outcomes throughout affected person populations, notably relating to outcomes resembling hospital size of keep (LOS) and value of care. Whereas extreme circumstances of bronchiolitis the place HFNC was used have been related to symptom enchancment and decreased LOS and value, HFNC use in gentle to reasonable circumstances has been related to much less symptom enchancment, together with elevated LOS and value.

The aim of this research was to discover the connection between HFNC utilization for non-intensive care unit (ICU) sufferers and affected person outcomes, LOS and value of care. Researchers reviewed information from 20 hospitals within the Pediatric Well being Data System. The information included sufferers youthful than 2 years with a principal or secondary analysis of acute bronchiolitis. Researchers categorized these hospitals primarily based on the proportion of non-ICU sufferers handled with HFNC into low, reasonable or excessive non-ICU HFNC utilization (NIHU).

Outcomes confirmed that LOS was longer for sufferers in reasonable to excessive NIHU hospitals in comparison with low NIHU hospitals. Evaluation of value of care confirmed comparable outcomes, the place reasonable and excessive NIHU hospitals confirmed larger prices in comparison with low NIHU hospitals, even after adjusting for scientific and demographic traits. Based mostly on their analyses, researchers estimate that prime NIHU hospitals have 5% to 30% longer LOS and a pair of% to 31% larger value of care than low NIHU hospitals.

“The big variety of sufferers admitted to youngsters’s hospitals implies that even small relative adjustments in these values could result in massive burdens to hospitals and the well being care system,” mentioned Winer.

This research means that larger NIHU could result in elevated total useful resource utilization for pediatric bronchiolitis sufferers. Extra analysis is required to evaluate how HFNC utilization impacts LOS and value of care throughout pediatric hospitals and if HFNC must be restricted in non-ICU sufferers.

Extra data:
Jeffrey C. Winer et al, Variation and Outcomes of Hospital-Stage Excessive-Move Nasal Cannula Utilization Outdoors of Intensive Care, Hospital Pediatrics (2022). DOI: 10.1542/hpeds.2022-006660

Offered by
Le Bonheur Youngsters’s Hospital

Excessive-flow nasal cannula utilization exterior of intensive care related to longer hospital stays, larger prices (2023, March 2)
retrieved 2 March 2023
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