Impact and efficacy of High-flow nasal cannula oxygen in Bronchiolitis

Abstract

Introduction: High flow nasal cannula (HFNC) is a new device for ventilatory support in children with bronchiolitis. The aim of this study is assess of the efficacy of HFNC therapy as compared to conventional respiratory support in the treatment of bronchiolitis. Methods: A retrospective study of infants under 24 months of age with moderate and severe bronchiolitis admitted in pediatric university hospital's Pediatric intensive care unit (PICU) before (P0: November 2013 to October 2015) and after introduction of HFNC (P1: November 2015 to October 2017). We compared intubation rate, length of hospital stay, intensive care length stay, length of oxygen therapy and adverse events in the two periods. Results: In P1, HFNC use decreased markedly the respiratory and heart rates with improvement of blood gas parameters. After the introduction of HFNC, only 8% of infants admitted to the PICU with bronchiolitis required intubation, compared with 20,7% in P0 (P<10-3). The HFNC group needed oxygen supplementation for three days less than the other group (p<10-3) and hospital and PICU stays were 4 days shorter (p<10-3). Few adverse events were reported in P1 (35% vs 14.9%, p<10-3). Conclusion: HFNC decreases the treatment failure rate and the duration of both oxygen therapy and PICU treatment by providing a comfortable and well-tolerated means of non invasive ventilatory support which implies that the HFNC should be the first choice for treating patients admitted to the PICU with moderate and severe bronchiolitis.