O076 The use of home humidified high-flow nasal cannula therapy for children with sleep-disordered breathing

Abstract Background Humidified High-flow nasal cannula (HHFNC) therapy is a method of respiratory support that facilitates delivery of humidified heated air or oxygen at a high flow rate. The physiological benefits of HHFNC include generation of a low level of positive airway pressure leading to alveolar recruitment and an increase in functional residual capacity; improvement in oxygenation, decrease in nasal resistance and washout of nasopharyngeal dead space. Whilst HHFNC is now used widely for children hospitalised with acute indications including bronchiolitis, there is a paucity of data on HHFNC in the home setting. Methods Single centre retrospective study of children treated with home HHFNC. Data include demographic parameters, clinical indication, previous CPAP/BPAP use, age at initiation and flow rate, polysomnography results and adverse events. Progress A literature review about the use of HHFNC in the home setting has been undertaken. Median (Interquartile range [IQR]) age of initiating home HFNC in 11 children was 60 (12.5, 138) months. Indications were obstructive sleep apnoea (3; 27%), neuromuscular disease (4; 36%), hypoventilation (2; 18%), chronic lung disease (1; 9%) and central sleep apnoea (1; 9%). HHFNC was instituted as palliative management for five patients. Ten (91%) patients failed CPAP/BPAP. No serious adverse effects were observed. Issues with HHFNC included increased secretions (1, 9%), increased moisture (1, 9%) and higher flow rate (2; 18%). Intended outcome and impact The study aims to describe the safety and tolerability of HHFNC in the home setting and add to the literature on its use across different clinical settings.