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Using high-flow nasal cannulas for infants with bronchiolitis admitted to paediatric wards is safe and feasible

Paula Heikkilä1, Paula Sokuri1, Minna Mecklin1

  • 1Centre for Child Health Research, Tampere University and University Hospital, Tampere, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|May 27, 2018
PubMed

Insights

High-flow nasal cannula (HFNC) therapy is effective for infant bronchiolitis, with 86% of infants responding well. Early indicators of success include oxygen support needs and heart rate, not respiratory rate.

Area of Science:

  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • High-flow nasal cannula (HFNC) use for infant bronchiolitis is rising but lacks extensive study.
  • Understanding HFNC efficacy and predictors of success is crucial for optimizing infant respiratory support.

Purpose of the Study:

  • To evaluate the outcomes of HFNC therapy in infants with bronchiolitis.
  • To compare infants who responded to HFNC with those who did not.

Main Methods:

  • Retrospective study of 88 infants under 12 months treated with HFNC across six Finnish hospitals (2012-2015).
  • Data collected from patient files included underlying factors, clinical parameters, and HFNC treatment outcomes.
  • Treatment failure was defined as transfer to alternative respiratory support.

Main Results:

  • HFNC was successful in 86% (76/88) of infants, including all 53 on pediatric wards and 23/35 in pediatric intensive care units (PICUs).
  • Responders showed significantly lower heart rates and higher oxygen saturation at 60 minutes post-HFNC initiation.
  • Respiratory rate changes were less consistent, with non-responders showing higher rates at later time points (180 and 360 minutes).

Conclusions:

  • Oxygen support needs and heart rate appear to be early predictors of HFNC success in hospitalized infants with bronchiolitis.
  • Respiratory rate was not a reliable early predictor of HFNC therapy success in this cohort.
Abstract

Keywords:
BronchiolitisHigh-flow oxygen cannulaInfantOxygen saturationRespiratory rate

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