High-flow nasal cannula oxygen therapy for infants with bronchiolitis: pilot study

Mayfield, Sara, Bogossian, Fiona, O'Malley, Lee and Schibler, Andreas (2014) High-flow nasal cannula oxygen therapy for infants with bronchiolitis: pilot study. Journal of Paediatrics and Child Health, 50 5: 373-378. doi:10.1111/jpc.12509

Author Mayfield, Sara
Bogossian, Fiona
O'Malley, Lee
Schibler, Andreas
Title High-flow nasal cannula oxygen therapy for infants with bronchiolitis: pilot study
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
ISSN 1440-1754
Publication date 2014-05-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/jpc.12509
Open Access Status Not yet assessed
Volume 50
Issue 5
Start page 373
End page 378
Total pages 6
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Aim
Formatted abstract
Aim: To obtain data on the safety and clinical impact of managing infants with bronchiolitis on the ward with high-flow nasal cannula (HFNC) treatment.
Methods: A prospective pilot study was conducted of 61 infants aged <12 months with bronchiolitis and oxygen requirement presenting to the emergency department. HFNC was commenced at 2?L/kg/min, and fraction of inspired oxygen was titrated to oxygen saturation > 94%. A standard-treatment group (n = 33) managed with standard low-flow subnasal oxygen during the same time period was retrospectively identified.
Results: Admission demographics, heart rate (HR) and respiratory rate (RR) were similar in test and standard-treatment groups. Responders and non-responders to HFNC were identified within 60?min of treatment. Non-responders to HFNC requiring paediatric intensive care unit (PICU) admission showed no change in HR and RR, whereas responders showed decreases in HR and RR (P < 0.02). Patients receiving HFNC were four times less likely to need PICU admission than the standard treatment group (OR 4.086, 95%CI 1.0-8.2; P = 0.043). No adverse events such as pneumothorax, bradycardia, bradypnoea, emergency intubation or cardiopulmonary resuscitation were observed. No patients admitted to the PICU required intubation.
Conclusions: HFNC treatment in the paediatric ward is safe. Non-responders requiring PICU admission can be identified within the first hour of HFNC treatment by monitoring HR and RR. It is feasible to undertake a randomised controlled trial based on this pilot with the aim of decreasing PICU admissions.
Keyword Bronchiolitis
High-flow nasal cannula
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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