High flow nasal cannulae therapy in infants with bronchiolitis.
OBJECTIVE
To determine whether the introduction of heated humidified high-flow nasal cannulae (HFNC) therapy was associated with decreased rates of intubation for infants <24 months old with bronchiolitis admitted to a pediatric intensive care unit (PICU).


METHODS
A retrospective chart review of infants with bronchiolitis admitted before and in the season after introduction of HFNC.


RESULTS
In the season after the introduction of HFNC, only 9% of infants admitted to the PICU with bronchiolitis required intubation, compared with 23% in the prior season (P=.043). This 68% decrease in need for intubation persisted in a logistic regression model controlling for age, weight, and RSV status. HFNC therapy resulted in a greater decrease in respiratory rate compared with other forms of respiratory support, and those infants with the greatest decrease in respiratory rate were least likely to be intubated. In addition, median PICU length of stay for children with bronchiolitis decreased from 6 to 4 days after the introduction of HFNC.


CONCLUSIONS
We hypothesize that HFNC decreases rates of intubation in infants with bronchiolitis by decreasing the respiratory rate and work of breathing by providing a comfortable and well-tolerated means of noninvasive ventilatory support.
McKiernan
Christine
C
Department of Pediatrics, Tufts University School of Medicine, Baystate Children's Hospital, Springfield, MA, USA.
Chua
Lee Chadrick
LC
Visintainer
Paul F
PF
Allen
Holley
H
D001988:Bronchiolitis / Q000628:therapy*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D009666:Nose; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome