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Nasal Continuous Positive Airway Pressure in Bronchiolitis: A Randomized Controlled Trial.

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  • 1Department of Pediatrics, St. Stephens Hospital, Tis Hazari, Delhi, India. Correspondence to: Dr Sandeep Narayan Lal, Department of Pediatrics, St Stephens Hospital, Tis Hazari, Delhi 110054, India. sandeep.nlal@gmail.com.

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Nasal continuous positive airway pressure (nCPAP) significantly reduced respiratory distress in infants with bronchiolitis compared to standard care alone. This finding supports nCPAP as an effective intervention for managing respiratory distress in young children.

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Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Critical Care

Background:

  • Bronchiolitis is a common viral respiratory infection in infants, often causing significant respiratory distress.
  • Current management primarily focuses on supportive care, with limited interventions proven to effectively alleviate respiratory distress.

Purpose of the Study:

  • To evaluate the efficacy of nasal continuous positive airway pressure (nCPAP) in reducing respiratory distress among hospitalized infants diagnosed with bronchiolitis.

Main Methods:

  • A randomized controlled trial was conducted involving 72 infants under one year of age hospitalized with bronchiolitis.
  • Infants were randomized to receive either standard care or standard care plus nCPAP within the first hour of admission.
  • Respiratory rate, Silverman-Anderson score, and Modified Pediatric Society of New Zealand Severity Score were assessed after 60 minutes.

Main Results:

  • The nCPAP group showed a significantly greater reduction in respiratory rate (P=0.008) compared to the standard care group.
  • Mean changes in Silverman-Anderson score (P=0.029) and Modified Pediatric Society of New Zealand Severity Score (P=0.012) were significantly more favorable in the nCPAP group.
  • 14 out of 32 infants in the nCPAP group experienced a respiratory rate change ≥10, versus 5 out of 35 in the standard care group.

Conclusions:

  • Nasal continuous positive airway pressure (nCPAP) is an effective intervention for significantly reducing respiratory distress in infants with bronchiolitis.
  • The study demonstrates that nCPAP offers a significant advantage over standard care in improving respiratory parameters in this patient population.