High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

Milési, Christophe; Essouri, Sandrine; Pouyau, Robin; Liet, Jean-Michel; Afanetti, Mickael; Portefaix, Aurélie; Baleine, Julien; Durand, Sabine; Combes, Clémentine; Douillard, Aymeric; Cambonie, Gilles; Pédiatriques, Groupe Francophone de Réanimation et d’Urgences

doi:10.1007/s00134-016-4617-8

Cited by 231 publications

(264 citation statements)

References 40 publications

Supporting

Mentioning

217

Contrasting

Unclassified

Order By: Relevance

“…It is important to emphasize that most bronchiolitis, even the most severe forms, do not require invasive mechanical ventilation with the contemporary care [24]. In our centers about 2% of bronchiolitis are admitted to a critical care unit, and between 30% and 50% of them require finally invasive mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation

Cruces

González‐Dambrauskas

Quilodran³

et al. 2017

BMC Pulm Med

View full text Add to dashboard Cite

Background: Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. Methods: Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV. Shortly after intubation studies of pulmonary mechanics were performed using inspiratory and expiratory breath hold. The maximum inspiratory and expiratory flow (QI and QE) as well as peak inspiratory (PIP), plateau (PPL) and total expiratory pressures (tPEEP) were measured. Inspiratory and expiratory resistances (RawI and RawE) and Time Constants (K TI and K TE ) were calculated. Results: We included 16 patients, of median age 2.5 (1-5.8) months. Bronchiolitis due to respiratory syncytial virus was the main etiology (93.8%) and 31.3% had comorbidities. Measured respiratory pressures were PIP 29 (26-31), PPL 24 (20-26), tPEEP 9 [8-11] cmH2O. Elastic component of the working pressure was significantly higher than resistive and both higher than threshold (tPEEP -PEEP) (P < 0.01). QI was significantly lower than Conclusions: Analysis of respiratory mechanics of infants with severe bronchiolitis receiving MV shows that the elastic component of the working pressure of the respiratory system is the most important. The elastic and resistive components in conjunction with flow profile are characteristic of restrictive diseases. A better understanding of lung mechanics in this group of patients may lead to change the traditional ventilatory approach to severe bronchiolitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation

Cruces

González‐Dambrauskas

Quilodran³

et al. 2017

BMC Pulm Med

View full text Add to dashboard Cite

show abstract

“…The multicentre RCT reported by Milesi and colleagues in a recent article in Intensive Care Medicine is therefore a welcome addition to the literature [10]. The TRAMON-TANE study was performed at five French paediatric intensive care units (PICU) and randomised 142 infants aged <6 months with moderate/severe bronchiolitis to either HFNC or nasal continuous positive airway pressure (CPAP).…”

mentioning

confidence: 99%

Glass half empty or half full? The story of high-flow nasal cannula therapy in critically ill children

Ramnarayan

Schibler

2017

Intensive Care Med

View full text Add to dashboard Cite

“…These data pave the way for a trial of oxygenation targets in critically ill children. The TRAMONTANE study randomized infants < 6 months with moderate/severe bronchiolitis to either high-flow nasal cannula (HFNC) or continuous positive airway pressure (CPAP) with cross-over allowed [14]. Overall, patients in both groups were rarely intubated, with similar rates of rescue using the alternative non-invasive modality, suggesting that clinician preference may be more important than the modality chosen even though initial randomization to HFNC was slightly less efficacious.…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Focus on paediatrics: 2017

Weiss

Peters

2017

Intensive Care Med

View full text Add to dashboard Cite

High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

Cited by 231 publications

References 40 publications

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation

Glass half empty or half full? The story of high-flow nasal cannula therapy in critically ill children

Focus on paediatrics: 2017

Contact Info

Product

Resources

About