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Humidified high-flow nasal cannula oxygen in bronchiolitis reduces need for invasive ventilation but not intensive

Chong Tien Goh1, Lynette J Kirby1, David N Schell1

  • 1Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|May 26, 2017
PubMed

Insights

Humidified high-flow nasal cannula oxygen (HHFNC) did not decrease paediatric intensive care unit (PICU) admissions for bronchiolitis. However, HHFNC use outside the PICU reduced the need for invasive ventilation and shortened hospital stays.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Neonatal and pediatric respiratory care

Background:

  • Bronchiolitis is a common pediatric respiratory infection requiring intensive care.
  • The use of humidified high-flow nasal cannula (HHFC) oxygen outside the pediatric intensive care unit (PICU) has become widespread.
  • Changes in PICU admission patterns and ventilation requirements are anticipated with HHFC use.

Purpose of the Study:

  • To evaluate the impact of HHFC oxygen use outside the PICU on admission rates and ventilation requirements for pediatric patients with bronchiolitis.
  • To describe changes in PICU admission patterns and ventilation needs following HHFC implementation.

Main Methods:

  • Retrospective study design.
  • Comparison of bronchiolitis patients admitted to the PICU before and after HHFC implementation (2008, 2011, 2013).
  • Analysis of PICU admission rates, intubation rates, and length of stay.

Main Results:

  • HHFC use did not reduce PICU admissions.
  • Intubation rates decreased significantly from 22.2% in 2008 to 7.8% in 2013.
  • Hospital length of stay significantly decreased following HHFC introduction.
  • Younger age (<6 months) and RSV bronchiolitis were associated with higher HHFC failure rates.

Conclusions:

  • HHFC oxygen used outside the PICU did not reduce PICU admissions or length of stay for bronchiolitis patients.
  • HHFC implementation was associated with a decreased need for invasive ventilation.
  • HHFC therapy contributed to a reduced overall hospital length of stay.
Abstract

Keywords:
bronchiolitisgeneral paediatricshigh-flow nasal cannulaintensive care

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