Severe pneumonia in infants. Major manifestations include hypoxemia, respiratory distress, retained airway secretions, and impaired airway clearance.
Conditions
Interventions
Intervention group:HFNC combined with sequential multi-position nursing
Control group:HFNC combined with sequential multi-position nursing
Sponsors
The Second Affiliated Hospital of Wenzhou Medical University
Eligibility
Sex/Gender
All
Age
No minimum to 1 Years
Inclusion criteria
Inclusion criteria: 1.Infants aged 2 to 12 months. 2.Diagnosed with severe pneumonia according to the hospitalization and danger signs criteria in the Guidelines for the Management of Community-Acquired Pneumonia in Children 2024 revision, with at least one of the following manifestations: refusal to feed, persistent vomiting, lethargy or disturbed consciousness, central cyanosis, severe respiratory distress, or SpO2 below 92%. 3.Clinically assessed as requiring heated humidified high-flow nasal cannula oxygen therapy HFNC, including infants with moderate hypoxemia, inadequate response to conventional oxygen therapy, respiratory distress, or increased work of breathing. 4.Enrollment and baseline assessment completed within 12 hours after HFNC initiation. 5.Relatively stable vital signs, with SpO2 at or above 92% or stable compared with baseline, heart rate and respiratory rate within ±20% of the age-specific reference range, stable circulation, and no immediate indication for endotracheal intubation. 6.Able to complete position changes with assistance from medical staff or caregivers. 7.Written informed consent provided by parents or legal guardians.
Exclusion criteria
Exclusion criteria: 1.Patients with major structural lung diseases, such as pulmonary tuberculosis, bronchopulmonary dysplasia, or congenital pulmonary cysts. 2.Patients with contraindications to HFNC therapy, such as the need for emergency intubation, frequent apnea requiring continuous intervention, untreated pneumothorax, severe disturbance of consciousness, or inability to properly wear nasal prongs due to severe facial deformity or injury. 3.Patients with severe heart disease, neurological disorders, or other underlying conditions that may affect positional changes. 4.Patients with circulatory instability, such as persistent hypotension or severe arrhythmia, or conditions unsuitable for positional intervention, such as traumatic brain injury or intracranial hypertension. 5.Patients with severe malnutrition, immunodeficiency, malignant tumors, or other conditions that may significantly affect the disease course and outcome assessment. 6.Infants with developmental delay, such as those who are unable to lift their head or have unstable head control. 7.Patients who are currently participating in other interventional clinical studies. 8.Patients whose family members refuse to participate in the study procedures or withdraw from the study midway.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in lung ultrasound score(?LUS); | — |
Secondary
| Measure | Time frame |
|---|---|
| Pediatric Early Warning Score;Improvement in oxygenation;Indicated suction frequency;Change in inflammatory markers;HFNC-related adverse events;Length of hospital stay and treatment outcome; | — |
Countries
China
Contacts
Public ContactWenyuan Zhuang
The Second Affiliated Hospital of Wenzhou Medical University
Outcome results
None listed