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Nasal high flow therapy for bronchiolitis

Donna Franklin1,2,3,4,5, Letitia Miller6, Trang Mt Pham4

  • 1Children's Emergency and Critical Care Collaborative Research Group, Gold Coast University Hospital, Gold Coast, Queensland, Australia.

Journal of Paediatrics and Child Health
|May 22, 2024
PubMed

Insights

Nasal high-flow therapy is increasingly used for infant bronchiolitis. This study found infants receiving high-flow had more severe disease but also more intensive care admissions and longer hospital stays.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Critical Care

Background:

  • Nasal high-flow therapy (NHFT) use in infants with bronchiolitis has increased.
  • Evidence suggests NHFT may reduce escalation of care.
  • The impact of recent evidence on clinical practice for NHFT remains unclear.

Purpose of the Study:

  • To investigate the clinical practice of NHFT in infants with bronchiolitis.
  • To assess the factors influencing the choice between standard oxygen and NHFT.
  • To evaluate the outcomes associated with initial oxygen therapy choice.

Main Methods:

  • Prospective observational study over 6 months in six Australian hospitals.
  • Included infants admitted with bronchiolitis requiring oxygen therapy.
  • Disease severity assessed by physiological parameters; outcomes included length of stay and ICU transfers.

Main Results:

  • Infants receiving NHFT showed higher respiratory rates, heart rates, and early warning scores.
  • NHFT was associated with a longer hospital length of stay (0.6 days).
  • Higher intensive care unit admission rates for NHFT (23.3%) versus standard oxygen (10.4%).

Conclusions:

  • Infants with greater bronchiolitis severity are more likely to receive NHFT.
  • NHFT use was associated with increased frequency of intensive care unit escalation.
Abstract

Keywords:
bronchiolitisoxygen therapypaediatrics

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