الفهرس 
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Abstract
SUMMARY
N
oninvasive ventilation (NIV) has become the optimal modality for initial respiratory support among children in respiratory distress.
Noninvasive ventilation (NIV) refers to the delivery of mechanical ventilation to the lungs using techniques that do not require an invasive artificial airway (ETT, TT).
Continuous positive airway pressure (CPAP) and humidified high flow nasal cannula (HFNC) provides constant flow to maintain a target distending pressure to the lower airway (Oymar, 2015).
Continuous positive airway pressure (CPAP) is a type of positive airway pressure, where the air flow is introduced into the airways to maintain a continuous pressure to constantly open airway, in patients who are breathing spontaneously.
Increased pressure in the airways also allows for better distribution of gases, which leads to an increase in alveolar pressure and re expansion of collapsed alveoli.
High-flow nasal cannula (HFNC) is a technique for non-invasive respiratory support. It has been primarily developed for infants as an alternative to noninvasive positive pressure ventilation (nasal continuous positive airway pressure (nCPAP)). Nowadays this technique is being used progressively throughout all pediatric age groups
Most of the evidence supporting the use of high flow in infants and children relates to bronchiolitis. Bronchiolitis is one of the most common reasons in infants for hospitalization worldwide. Current approach to management of hospitalized infants with bronchiolitis is largely supportive.
This study had shown that the effectiveness of HFNC is similar to CPAP, with comparable effects on vital data, arterial blood gases, need of intubation and length of admission.
This observational study conducted on children who were admitted to pediatric ICU, Children’s Hospital, Ain Shams University, in the time period between January 2018 to June 2019 (18 months); with acute respiratory failure (ARF). Those patients were treated with non-invasive ventilation (NIV) according to inclusion criteria.
Our study included 22 males (45%) and 18 females (55%). Although the inclusion criteria included all patients aged 1month to 5 years yet the mean age in our study group was 2.5 months. This can be explained by the high incidence of bronchopneumonia and bronchiolitis in this age group.
As regards the cause of respiratory failure, half of our patients were diagnosed to have bronchopneumonia while the other half were diagnosed with bronchiolitis.The severity of condition was assessed by PIM2 score (pediatric index of mortality).
The study population was randomly allocated on respiratory support in which half of patients were on CPAP device while other half were on HFNC device.
As regards PH value, there was no significant change on admission compared to PH value after 24 hours, this can be explained by the fact that PH value was within normal range since admission so no significant change was expected on follow.
HFNC group was as significant as Ncpap in treatment of bronchiolitis and CAP regarding length of admission in PICU and progress of vital data for patient between 1 month to 5 years old. In addition patient diagnosed bronchilitis had better outcome than bronchopneumonia patients