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A child with respiratory distress is on high-flow nasal cannula (HFNC) at FiO₂ 50%. Which of the following is the correct step in management?
Question

A child with respiratory distress is on high-flow nasal cannula (HFNC) at FiO₂ 50%. Which of the following is the correct step in management?

A.

Increase FiO₂ beyond 60% if hypoxia persists

B.

Always add humidifier and maintain adequate moisture

C.

Switch directly to invasive ventilation without trial

D.

Use HFNC without humidification for short periods

Correct option is B

HFNC requires heated humidification to prevent mucosal drying, maintain airway clearance, and improve oxygenation. FiO₂ > 50% is avoided long-term to prevent oxygen toxicity.
Explanation of options: (a) ✘ Increasing FiO₂ > 60% risks oxygen toxicity, not first step. (b) ✔ Correct; humidification is mandatory in HFNC therapy. (c) ✘ Invasive ventilation only if HFNC fails. (d) ✘ HFNC without humidification causes mucosal damage.

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