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Respiratory support for infants with bronchiolitis, a narrative review of the literature

Donna Franklin1, John F Fraser2, Andreas Schibler3

  • 1Paediatric Critical Care Research Group, Lady Cilento Children's Hospital, Australia; Mater Research Institute, The University of Queensland, Brisbane, Australia; The University of Queensland, School of Medicine, Brisbane, Australia; Critical Care Research Group, Adult Intensive Care Service, The Prince Charles Hospital, Brisbane, Australia.

Paediatric Respiratory Reviews
|May 12, 2019
PubMed

Insights

Non-invasive respiratory support, including nasal high flow therapy, effectively manages infant bronchiolitis, reducing hospital interventions like intubation and lowering healthcare costs.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Critical Care Medicine

Background:

  • Bronchiolitis is a prevalent viral illness impacting infants under 12 months.
  • Effective respiratory support is crucial for hospitalized infants with bronchiolitis.

Purpose of the Study:

  • To review current knowledge on respiratory support for infants with bronchiolitis.
  • To evaluate the impact of different respiratory support strategies on patient outcomes and healthcare costs.

Main Methods:

  • Systematic electronic search of MEDLINE, Cochrane, CINAHL, and EMBASE databases.
  • Inclusion of clinical trials focusing on respiratory support management strategies for infant bronchiolitis.
  • Analysis of 33 relevant papers, including nine randomized controlled trials.

Main Results:

  • Non-invasive respiratory support significantly reduces the need for escalated therapy, including intubation.
  • Non-invasive ventilation demonstrates clear economic benefits.
  • High-flow therapy is safe and effective in general ward settings for infant bronchiolitis.

Conclusions:

  • Early implementation of non-invasive respiratory support (nasal high flow therapy, non-invasive ventilation) can decrease ICU admissions and intubation rates.
  • Non-invasive respiratory support offers potential impacts on healthcare costs.
  • Evidence supports the safety and quality of high-flow therapy in non-ICU environments.

Keywords:
BronchiolitisInfantInvasive mechanical ventilationNasal high flowNon-invasive ventilationRespiratory syncytial virus (RSV)Standard oxygen therapy

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