Efeitos da Cânula Nasal de Alto Fluxo (CNAF) comparado com VNI-Binível em crianças e adolescentes asmáticos em agudização: ensaio clínico randomizado

Abstract

Introduction: Asthma is a chronic inflammatory disease characterized by recurrent and reversible episodes of airway obstruction, with clinical symptoms of cough, shortness of breath and wheezing. It is estimated that 300 million people suffer from asthma worldwide, of which 25% are children and adolescents, generating high hospital costs. In its pharmacological treatment, anti-inflammatory agents, inhaled corticosteroids, bronchodilators and oxygen therapy are used. In the non-pharmacological way, non-invasive ventilation (NIV), in the Bilevel mode, has been shown to be effective, and although it is comfortable, for children and adolescents, they require more comfortable alternatives, and with the same level of effectiveness, as may be the case, of the High Flow Nasal Cannula (HFNC).Objectives: The aim of this study was to evaluate the effects of HFNC therapy compared to NIV in the Beveled modality in hospitalized asthmatic patients during the period of acute disease. Method: This is a randomized clinical trial controlled, where treatment therapy was instituted with HFNC and NIV in the bilevel modality in hospitalized patients diagnosed with asthma during the acute period. After randomization, these patients underwent pulmonary function test, peak flow, vital signs and severity scores PIS, PASS, SBP and after treatment for 45 minutes, were reassessed until discharge. Results: In the results collected from 50 patients, of which 25 were allocated to the NIV-Bilevel group (GI) and 25 to the CNAF (G-II), after 45 minutes of therapy, there was a reduction in FEV1, higher in the GI group than in the G -II, which presented shorter days of oxygen use than GI; Regarding the use of inhaled bronchodilator, as measured by Salbutamol jets, G-I used more than G-II. Finally, with regard to length of stay, GI remained longer in hospital (6.07 ± 1.97 days) than G-II (4.35 ± 1.37 days), and consumed more bronchodilator than G -II. Conclusion: According to our results, HFNC, has been shown to be an alternative treatment for asthma attacks, with reduced hospitalization days, reduced use of oxygen and inhaled bronchodilator, and is a viable and safe resource, comfortable for the patient. and better adaptation, both by the patient and by the professional team, reported bedside, showing no inferiority in relation to the conventional treatment of NIV.