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Randomised controlled trial of nasal continuous positive airways pressure (CPAP) in bronchiolitis

Lena P Thia1, Sheila A McKenzie, Tom P Blyth

  • 1Department of Paediatric Respiratory Medicine, Royal London Hospital, Whitechapel Road, London, UK. lthia@doctors.org.uk

Archives of Disease in Childhood
|March 9, 2007
PubMed

Insights

Continuous positive airway pressure (CPAP) effectively improves ventilation in infants with bronchiolitis and hypercapnoea compared to standard treatment. This approach offers a significant reduction in carbon dioxide levels.

Area of Science:

  • Pediatric Respiratory Medicine
  • Critical Care
  • Neonatology

Background:

  • Bronchiolitis is a common viral respiratory infection in infants.
  • Hypercapnoea in bronchiolitis indicates impaired gas exchange.
  • Standard treatment (ST) for severe bronchiolitis includes supplemental oxygen and intravenous fluids.

Purpose of the Study:

  • To compare the efficacy of continuous positive airway pressure (CPAP) versus standard treatment (ST) in managing bronchiolitis.
  • To assess the impact of CPAP on ventilation parameters in infants with bronchiolitis and hypercapnoea.

Main Methods:

  • A randomized crossover study design was employed.
  • Infants under 1 year with bronchiolitis and capillary PCO2 >6 kPa were enrolled.
  • Participants received CPAP and ST sequentially for 12-hour periods.

Main Results:

  • CPAP significantly reduced PCO2 by 0.92 kPa after 12 hours, whereas ST resulted in a slight increase (0.04 kPa).
  • Initial CPAP treatment led to a greater PCO2 reduction compared to CPAP as a second-line treatment.
  • No significant differences were observed in secondary outcomes such as pH, respiratory rate, or pulse rate.

Conclusions:

  • CPAP is an effective intervention for improving ventilation in infants with bronchiolitis and hypercapnoea.
  • CPAP demonstrates a favorable safety profile with no reported complications in this study population.
Abstract

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