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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Serious Air Leak Syndrome Complicating High-Flow Nasal Cannula Therapy: A Report of 3 Cases
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Serious Air Leak Syndrome Complicating High-Flow Nasal Cannula Therapy: A Report of 3 Cases

机译：严重漏气综合征并发高流量鼻导管治疗：3例报告

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Despite the absence of clinical safety data, heated, humidified high-flow nasal cannula (HHFNC) therapy is increasingly being used as an alternative to positive-pressure ventilation in pediatrics. This use of HHFNC is "off label" because the US Food and Drug Administration's approval for these devices was only for air humidification and not as a modality to provide positive distending pressure. For the first time we describe 3 cases who developed serious air leaks related to HHFNC therapy. The first child was a previously healthy 2-month-old male infant with respiratory syncytial virus bronchiolitis who developed a right pneumothorax on day 5 of his illness at 8 liters per minute (lpm). He subsequently required intubation and ventilation for 14 days. The second case involved an otherwise healthy 16-year-old boy with cerebral palsy who developed pneumomediastinum and died of its complications. He was receiving 20 lpm HHFNC therapy when he developed pneumomediastinum. The third case involved a 22-month-old, previously healthy boy who developed subdural hematoma secondary to abuse. He developed a right pneumothorax while receiving HHFNC at a flow of 6 lpm, requiring chest tube placement. These cases emphasize the need for extreme caution while using HHFNC for the off-label indication of providing positive distending pressure in children, especially at flows higher than the patient's minute ventilation. A more detailed study to specifically look at the serious adverse events related to HHFNC is urgently needed. Pediatrics 2013;131:e939-e944
机译：尽管缺乏临床安全性数据，但加热，加湿的高流量鼻插管（HHFNC）治疗越来越多地被用作儿科正压通气的替代方法。 HHFNC的这种使用已被取消，因为美国食品药品监督管理局（US Food and Drug Administration）批准这些设备仅用于空气加湿，而不能作为提供正膨胀压力的方式。我们首次描述了3例发生与HHFNC治疗有关的严重漏气的病例。第一个孩子是一个先前健康的2个月大的婴儿，患有呼吸道合胞病毒细支气管炎，他在病情第5天以每分钟8升（lpm）的速度出现了右气胸。随后，他需要插管和通气14天。第二例涉及一名原本健康的16岁男孩脑瘫，该男孩发展为纵隔肺炎并因并发症而死亡。他患上了纵隔肺炎时，他接受了每小时20次的HHFNC治疗。第三例涉及一个22个月大，以前健康的男孩，该男孩因滥用而发展为硬膜下血肿。他在以6 lpm的流量接受HHFNC时出现了右气胸，需要放置胸管。这些情况强调了在将HHFNC用于儿童正向扩张压力的标签外指征时尤其要格外小心，尤其是在高于患者分钟通气量的流量下。迫切需要进行更详细的研究，专门研究与HHFNC相关的严重不良事件。儿科2013; 131：e939-e944

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