Severe bronchiolitis outside pediatric intensive care units: the role of high-flow nasal cannula therapy

Abstract

Objective: To assess the benefits of High-Flow Nasal Cannula (HFNC) therapy in managing severe bron- chiolitis outside the PICU and identify associated factors for treatment failure. Methods: A 6-month observational prospective monocentric study included infants under 24 months with severe bronchiolitis treated with HFNC. Mild/moderate cases and other causes of respiratory distress were excluded. Results: Among 489 hospitalized infants, 50 (10%) received HFNC. The mean age was 3 months. The mean HFNC duration was 3.25 days, significantly shorter than low-flow nasal cannula (5.37 days, p<0.05). Factors associated with HFNC failure included congenital heart disease (p=0.03), history of neonatal mechanical ventilation (p=0.05), and initial treatment with low-flow nasal cannula (p=0.04). Conclusion: HFNC is a safe alternative in general pediatric wards. However, patients with comorbidities require close monitoring due to a higher risk of failure.