{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:31:34Z","timestamp":1787031094419,"version":"build-2736575974"},"reference-count":18,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>High-flow nasal cannula (HFNC) has been used in the treatment of pediatric asthma, although high-quality data comparing HFNC to aerosol mask nebulizer are lacking. We hypothesized that HFNC would perform similarly to the aerosol mask for meaningful clinical outcomes in children with critical asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We retrospectively reviewed the medical records of children with critical asthma (age 2\u201317 y) with a modified pulmonary index score (MPIS) \u2265 8 admitted to our pediatric ICU as part of a quality improvement project. Patients were managed with our MPIS-based, respiratory therapist-driven protocol. Subjects were divided into 2 cohorts by initial respiratory support: HFNC or aerosol mask. Data included demographics, initial respiratory support, and MPIS over time. Primary outcome was hospital length of stay (LOS). Secondary outcome was difference in MPIS over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We included 171 subjects, with 104 in the HFNC group and 67 in the aerosol mask group. Median (interquartile range [IQR]) age was lower in the HFNC group (5 [IQR 4\u20139] vs 7 [IQR 5\u201310] y,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006)], while other demographic characteristics were similar. Initial MPIS was similar between HFNC and aerosol mask groups (11 [IQR 9\u201312] vs 10 [IQR 9\u201312],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .15). There were no significant differences for hospital LOS (2.9 [IQR 2.1\u20133.9] vs 3.0 [IQR 2.3\u20134.4] d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .47), pediatric ICU LOS (1.9 [IQR 1.4\u20132.8] vs 1.8 [IQR 1.5\u20133.0] d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .92), or time to MPIS &lt; 6 (1.0 [IQR 0.6\u20131.6] vs 1.3 [IQR 0.8\u20131.9) d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .09) between the HFNC and aerosol mask groups, respectively. Median time on continuous albuterol was shorter in the HFNC group compared to the aerosol mask group (1.0 [IQR 0.7\u20131.8] vs 1.5 [IQR 0.9\u20132.3] d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .048). Of note, 16 (24%) subjects in the aerosol mask group were eventually treated with HFNC. Use of a helium-oxygen mixture and noninvasive ventilation was similar between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>HFNC performed similarly to aerosol mask in pediatric patients with critical asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.08740","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T14:50:44Z","timestamp":1620744644000},"page":"1240-1246","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["High-Flow Nasal Cannula in Pediatric Critical Asthma"],"prefix":"10.1177","volume":"66","author":[{"given":"Rachel M","family":"Gates","sequence":"first","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn E","family":"Haynes","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle J","family":"Rehder","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanecia O","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre T","family":"Rotta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G","family":"Miller","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3239"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05174"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05961"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2743-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03206-9"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24967"},{"key":"e_1_3_2_8_2","first-page":"2301712","article-title":"High-flow nasal cannula: a promising oxygen therapy for patients with severe bronchial asthma complicated with respiratory failure","volume":"2020","author":"Geng W","year":"2020","unstructured":"Geng W, , Batu W, , You S, , Tong Z, , He H. High-flow nasal cannula: a promising oxygen therapy for patients with severe bronchial asthma complicated with respiratory failure. Can Respir J, 2020; 2020:2301712.","journal-title":"Can Respir J"},{"issue":"6","key":"e_1_3_2_9_2","first-page":"615","article-title":"Value and safety of high flow oxygenation in the treatment of inpatient asthma: a randomized, double-blind, pilot study","volume":"18","author":"Raeisi S","year":"2019","unstructured":"Raeisi S, , Fakharian A, , Ghorbani F, , Jamaati HR, , Mirenayat MS. Value and safety of high flow oxygenation in the treatment of inpatient asthma: a randomized, double-blind, pilot study. Iran J Allergy Asthma Immunol, 2019; 18(6):615-623.","journal-title":"Iran J Allergy Asthma Immunol"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07147"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.10.075"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-017-0278-1"},{"issue":"6","key":"e_1_3_2_13_2","first-page":"642","article-title":"High flow nasal cannula oxygen therapy in patients with asthmatic crisis in the pediatric emergency department","volume":"90","author":"Gauto Ben\u00edtez R","year":"2019","unstructured":"Gauto Ben\u00edtez R, , Morilla Sanabria LP, , Pavlicich V, , Mesquita M. High flow nasal cannula oxygen therapy in patients with asthmatic crisis in the pediatric emergency department. Rev Chil Pediatr, 2019; 90(6):642-648.","journal-title":"Rev Chil Pediatr"},{"issue":"2","key":"e_1_3_2_14_2","first-page":"72","article-title":"Treatment with high-flow oxygen therapy in asthma exacerbations in a paediatric hospital ward: experience from 2012 to 2016","volume":"90","author":"Gonz\u00e1lez Mart\u00ednez F","year":"2019","unstructured":"Gonz\u00e1lez Mart\u00ednez F, , Gonz\u00e1lez S\u00e1nchez MI, , Toledo Del Castillo B, , P\u00e9rez Moreno J, , Medina Mu\u00f1oz M, , Rodriguez Jim\u00e9nez C, , Rodr\u00edguez Fern\u00e1ndez R. Treatment with high-flow oxygen therapy in asthma exacerbations in a paediatric hospital ward: experience from 2012 to 2016. An Pediatr (Barc), 2019; 90(2):72-78.","journal-title":"An Pediatr (Barc)"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2017.01.001"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06626"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0108"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07396"},{"key":"e_1_3_2_19_2","first-page":"918","volume-title":"Egan's Fundamentals of Respiratory Care","author":"Kacmarek RM","year":"2020","unstructured":"Kacmarek RM. Egan's Fundamentals of Respiratory Care. 12th Edition. St. Louis, MO: Elsevier, Inc; 2020: 918-921.","edition":"12"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.08740","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.08740","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.08740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:57:02Z","timestamp":1775465822000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.08740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,11]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.4187\/respcare.08740"],"URL":"https:\/\/doi.org\/10.4187\/respcare.08740","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5,11]]}}}