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Physiologic effect of high-flow nasal cannula in infants with bronchiolitis

Judith L Hough1, Trang M T Pham, Andreas Schibler

  • 11Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children's Hospital, South Brisbane, QLD, Australia. 2School of Physiotherapy, Australian Catholic University, Banyo, QLD, Australia. 3Critical Care of the Newborn Program, Mater Research, South Brisbane, QLD, Australia.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|April 8, 2014
PubMed

Insights

High-flow nasal cannula (HFNC) therapy at 8 L/min significantly increased lung volume and improved oxygenation in infants with bronchiolitis. This finding supports higher flow rates for better respiratory support in young children.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory physiology
  • Neonatology and infant respiratory support

Background:

  • Bronchiolitis is a common respiratory infection in infants, often requiring respiratory support.
  • High-flow nasal cannula (HFNC) therapy is increasingly used for respiratory distress in infants.
  • Understanding the physiological effects of HFNC in bronchiolitis is crucial for optimizing treatment.

Purpose of the Study:

  • To evaluate the impact of different high-flow nasal cannula (HFNC) flow rates on lung volumes and ventilation distribution.
  • To assess the effect of HFNC on continuous distending pressure and physiological parameters in infants with bronchiolitis.

Main Methods:

  • A prospective observational study was conducted in a pediatric intensive care unit (PICU).
  • Thirteen infants diagnosed with bronchiolitis received HFNC at flow rates of 2 L/min and 8 L/min.
  • Electrical impedance tomography (EIT) was used to measure end-expiratory lung volume and ventilation distribution.

Main Results:

  • Delivering HFNC at 8 L/min significantly increased global and anterior end-expiratory lung volumes compared to 2 L/min (p < 0.01).
  • Higher flow rates also led to improvements in respiratory rate, oxygen saturation (SpO2), and fraction of inspired oxygen (FIO2).
  • Continuous distending pressure changes were monitored via nasogastric tube.

Conclusions:

  • In infants with bronchiolitis, HFNC delivered at 8 L/min effectively increases end-expiratory lung volume.
  • Higher HFNC flow rates improve key physiological parameters including respiratory rate, SpO2, and FIO2.
  • These findings suggest that 8 L/min of HFNC is beneficial for managing respiratory distress in infants with bronchiolitis.
Abstract

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