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Nasal High Flow in Room Air for Hypoxemic Bronchiolitis Infants

Donna Franklin1,2,3,4,5, Franz E Babl5,6,7,8, Kristen Gibbons1,3

  • 1Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia.

Frontiers in Pediatrics
|November 12, 2019
PubMed

Insights

A small group of infants with bronchiolitis and hypoxemia can be successfully managed using only nasal high-flow therapy in room air. This approach led to shorter hospital stays and reduced respiratory support duration.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Critical Care

Background:

  • Bronchiolitis is a leading cause of infant hospital admissions, often necessitating oxygen therapy for hypoxemia.
  • The efficacy of nasal high-flow therapy in room air for managing hypoxemic infants with bronchiolitis remains under investigation.

Purpose of the Study:

  • To evaluate the outcomes of infants with bronchiolitis treated exclusively with nasal high-flow therapy in room air.
  • To compare these outcomes against infants receiving standard oxygen or high-flow therapy with supplemental oxygen.

Main Methods:

  • A planned sub-study within a multicenter randomized controlled trial.
  • Infants received high-flow therapy in room air if initial oxygen saturation was ≥85%.
  • Comparison between infants on high-flow room air only versus standard oxygen or high-flow with oxygen.

Main Results:

  • 10% (64/630) of infants initiated on high-flow room air remained on this therapy throughout their hospital stay.
  • These infants were typically older and presented with moderate hypoxemia.
  • Significantly shorter lengths of respiratory support and hospital stay were observed in the high-flow room air only group.

Conclusions:

  • Nasal high-flow therapy in room air can effectively manage hypoxemia in a select subgroup of infants with bronchiolitis.
  • No identifiable pre-enrollment factors predicted success with high-flow room air only therapy.

Keywords:
bronchiolitisnasal high flow therapyoxygen therapyrespiratory illnessroom air

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