Ajith, DivyaNamboodiripad, Aparna2025-10-132025-10-132025https://hdl.handle.net/20.500.14572/2628Divya Ajith Paediatric Resident, Jubilee Mission Medical College and Research Institute, Fathima Nagar, Mahatma Nagar, Nellikunnu, Thrissur – 680005 Kerala, India. Aparna Namboodiripad Associate Professor, Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Fathima Nagar, Mahatma Nagar, Nellikunnu, Thrissur - 680005 Kerala, India.Abstract: Introduction: Acute respiratory distress (ARD) is one of the most common causes for PICU admission among children. Though invasive mechanical ventilation is an effective respiratory support, it has many adverse effects. Hence newer modes of less invasive methods have been studied. High Flow Nasal Cannula therapy (HFNC) is a new mode of respiratory support which can efficiently deliver heated and humidified gas at very high flow rates. The studies on HFNC therapy in paediatric population is limited, but it is being used in many PICUs effectively for various indications. The aim of this study is to elucidate the clinical profile and outcome of HFNC therapy as a primary modality of treatment in children with ARD. Methods: Children aged one month to 14 years with ARD requiring HFNC respiratory support during PICU admission were recruited for the study. Demographics, clinical parameters, HFNC setting and outcome of HFNC therapy was documented in a proforma. Results: 144 children with ARD were assessed, of which 130 (90.3%) responded successfully to HFNC therapy, and 14 (9.7%) required more invasive support. Indications that required HFNC support included pneumonia (43.1%), bronchiolitis (31.2%), reactive airway disease (25%) and tracheal web (0.69%). Most HFNC failures happened in children with pneumonia (16.1% of all pneumonia cases). Conclusions: For children experiencing respiratory distress, HFNC is a primary respiratory support method that is both safe and effective. Children who respond well to HFNC exhibit a positive clinical response in the first few Correspondence hours.en-USPneumoniaReactive airway diseaseComfort scoreROX indexS/F ratioArticle