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High-flow nasal cannula (HFNC) therapy can reduce the work of breathing, provide continuous positive airway pressure, and possibly reduce anatomical dead space. It is increasingly being used in pediatric intensive care units, but whether HFNC therapy is safe and effective during interfacility transport is unclear. These investigators retrospectively studied 793 critically ill children (age, <2 years) who were transported by a specialized team from community hospitals to a single pediatric intensive care unit in Australia during 4-year periods immediately before and after implementation of HFNC therapy (2 L/kg/minute flow delivered via nasal cannula connected to a heated humidifier).
Mean transport time was 1.4 hours (range, 0.25–8 hours) and…