The role of high-flow nasal cannula in pediatric respiratory distress

Recently, high-flow nasal cannula (HFNC) oxygen therapy has been introduced as a non-invasive ventilation therapy in pediatric populations. It has shown great efficacy in managing respiratory distress in adult ’populations, and it has been associated with promising outcomes in pediatrics through the last two decades. HFNC provides heated and humidified air mixed with oxygen through a nasal cannula, resulting in better oxygenation and reduced respiratory distress. Additionally, it has a basic principle, which is setting oxygen flow higher than inspiratory demand flow based on the clinical situation. HFNC was originally used in pediatric intensive care units; however, its use has expanded to various pediatric settings and different respiratory conditions, such as bronchiolitis and asthma. Although evidence exploring the effectiveness of HFNC in managing respiratory distress in pediatrics has steadily grown, it is still limited compared to evidence on adults. This review explores the effectiveness of HFNC in pediatric respiratory distress, highlighting its implications and adverse effects. Current evidence shows that HFNC efficacy is comparable to other non-invasive ventilation modalities or higher in some cases. It is also considered generally safe, as it is associated with fewer adverse events and is easier to use. These results encourage further research focusing on the use of HFNC in more uncommon and severe respiratory distress conditions in pediatrics.