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High Flow Nasal Cannula and Non Invasive Ventilation for Acute Bronchiolitis in the Paediatric Wards
Luca Pierantoni1, Giacomo Stera2, Carlotta Biagi1
1Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Acta Paediatrica (Oslo, Norway : 1992)
|July 2, 2025
Summary
High-flow nasal cannula is a safe option for infant bronchiolitis. Continuous positive airway pressure and noninvasive ventilation may help selected infants in wards, but require careful monitoring.
Area of Science:
- Pediatric Respiratory Medicine
- Critical Care
Background:
- Bronchiolitis is a major cause of infant hospitalizations.
- High-flow nasal cannula (HFNC) is effective for infants not responding to standard oxygen.
- Evidence for continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) in wards is limited.
Purpose of the Study:
- To review the feasibility and criteria for initiating, titrating, and monitoring HFNC, CPAP, and NIV in infants with bronchiolitis on pediatric wards.
Main Methods:
- A narrative review of studies from PubMed and Cochrane Library (2000-2024).
- Focus on HFNC, CPAP, and NIV for bronchiolitis in pediatric wards.
Main Results:
- HFNC is a safe and effective treatment for bronchiolitis in pediatric wards.
- Limited evidence suggests CPAP and NIV may reduce the need for escalation in select cases outside the ICU.
Conclusions:
- CPAP and NIV in pediatric wards have limited safety concerns.
- While not superior to HFNC, CPAP and NIV can be rescue therapies when used selectively with trained staff and close monitoring.
- Further evidence could support standardization and improve resource allocation for respiratory support in bronchiolitis.
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