High-flow nasal cannula therapy for infants with bronchiolitis

Beggs, Sean; Wong, Zee Hame; Kaul, S; Ogden, Kathryn; Walters, Julia

doi:10.1002/14651858.cd009609.pub2

Cited by 113 publications

(83 citation statements)

References 34 publications

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“…[1] There is currently no proven effective therapy other than oxygen for hypoxic children (Table 1). [2,3] The following supportive treatments have been used for the management of bronchiolitis:…”

Section: Management Of Bronchiolitismentioning

confidence: 99%

Acute viral bronchiolitis in South Africa: Strategies for management and prevention

et al. 2016

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Section: Management Of Bronchiolitismentioning

confidence: 99%

Acute viral bronchiolitis in South Africa: Strategies for management and prevention

et al. 2016

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“…9,10 Such modalities aim to deliver a high concentration of oxygen, aid in the improvement of severe respiratory compromise, overcome airway resistance, reduce the work of breathing and respiratory muscle fatigue, and loosen thick intraluminal mucus. [11][12][13][14] HFNC is increasingly being utilized as an alternative respiratory support modality for critically ill infants and children with severe bronchiolitis. 9,10 Although the physiological effects of such devices are still not well understood, 11,12 they are widely considered to be less invasive, better tolerated, and possibly with lower comorbidity associated with intubation and mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

A comparison between high‐flow nasal cannula and noninvasive ventilation in the management of infants and young children with acute bronchiolitis in the PICU

Habra

Janahi

Dauleh

et al. 2020

Pediatric Pulmonology

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Background Different modalities of noninvasive respiratory support have been recommended for the management of acute bronchiolitis in the pediatric intensive care unit (PICU). High‐flow nasal cannula (HFNC) is among the new modalities that have been widely used in the last decade. Methods This is a retrospective study involving infants and young children between the ages of 1 month and 2 years during the respiratory season of 2016‐2017 (October‐May). We compared the failure rate of HFNC with the failure rates of bi‐level positive airway pressure (BiPAP) vs continuous positive airway pressure (CPAP) in the management of acute bronchiolitis in the PICU. Failure was defined as a change to another respiratory support modality or endotracheal intubation and mechanical ventilation. Results One hundred thirty‐seven patients met the inclusion criteria, of which 77 patients needed HFNC, 10 needed CPAP, and 50 were on BiPAP. Among baseline characteristics, there were significant variations in age among the three groups. HFNC had a higher failure rate compared with the other two noninvasive ventilation modalities (50.6% for HFNC [n = 39 out of 77] vs 0% for CPAP [n = 0 out of 10] vs 8% for BiPAP [n = 4 out of 50], P < .01). Among the 39 patients who failed HFNC, 90% were successfully shifted to BiPAP and weaned off later, whereas the other 4 were intubated and required mechanical ventilation. However, all four patients who failed BiPAP were intubated and mechanically ventilated. No respiratory complications or mortalities were reported in the three groups. No differences were observed among the three groups in terms of the lengths of PICU or hospital stays. Conclusions We observed a higher failure rate of HFNC compared with BiPAP or CPAP in the management of infants and children with acute bronchiolitis in the PICU. Further prospective randomized trials are recommended to confirm this finding.

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“…[26,27] However, systematic reviews have not yielded conclusive results as to whether either technique reduces intubation rates, largely due to a lack of prospective randomised controlled trials. [22,28] Even though there have been varying reports, there has been no consensus with regard to appropriate invasive mechanical ventilation strategies for infants with severe bronchiolitis. Pressure control or pressureregulated volume-controlled ventilation compared with volume-controlled ventilation, may deliver lower tidal volumes than those programmed in high resistance situations, leading to hypoventilation; [29] therefore, volume-controlled modes should be considered in children with bronchiolitis.…”

Section: Ventilatory Supportmentioning

confidence: 99%

Acute viral bronchiolitis in South Africa: Intensive care management for severe disease

2016

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High-flow nasal cannula therapy for infants with bronchiolitis

Abstract: High-flow nasal cannula therapy for infants with bronchiolitis (Review)

Cited by 113 publications

References 34 publications

Acute viral bronchiolitis in South Africa: Strategies for management and prevention

Acute viral bronchiolitis in South Africa: Strategies for management and prevention

A comparison between high‐flow nasal cannula and noninvasive ventilation in the management of infants and young children with acute bronchiolitis in the PICU

Acute viral bronchiolitis in South Africa: Intensive care management for severe disease

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