title: High flow therapy versus hypertonic saline in bronchiolitis: randomised controlled trial.
abstract: OBJECTIVE
  To demonstrate that heated humidified high-flow nasal cannula (HHHFNC) is superior to inhaled hypertonic saline solution (HSS) in improving respiratory distress in moderate bronchiolitis. In addition, it could improve comfort and reduce length of hospital stay (LOS) and admission to Paediatric Intensive Care Unit (PICU).
  
  
  METHODS
  Randomised Clinical Trial from 1 October 2010 to 31 December 2012.
  
  
  METHODS
  Two urban secondary (no PICU available) paediatric hospitalisation units.
  
  
  METHODS
  Hospitalised children aged up to 6 months with moderate acute bronchiolitis (Respiratory Distress Assessment Instrument, RDAI ≥4).
  
  
  METHODS
  Patients were randomised to HHHFNC or HSS. All of them received epinephrine as bronchodilator.
  
  
  RESULTS
  Primary outcome was difference in mean Respiratory Assessment Change Score (RACS) between both groups measured in six previously defined consecutive moments. Secondary outcomes were difference in mean comfort scores in this period, LOS and rate of PICU admission.
  
  
  RESULTS
  Seventy-five previously healthy patients were enrolled. Mean age was 2.4 months (95% CI 2.04 to 2.76). 43 were allocated to HSS group and 32 in HHHFNC. Data of 1 patient were lost, and 8 changed group over the study period. Intention-to-treat principle was applied. There were no significant differences in mean RACS and mean comfort scores between groups at the evaluation points. Median LOS or PICU admission rate were similar in both groups. No adverse events were observed.
  
  
  CONCLUSIONS
  HHHFNC was not superior to HSS in treatment of moderate acute bronchiolitis with respect to severity and comfort scores, LOS or PICU admission rate.
  NCT01873144.
authors: Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
authors: Mercedes
authors: M
authors: Bueno Campaña
authors: Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
authors: Jorge
authors: J
authors: Olivares Ortiz
authors: Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
authors: Cristina
authors: C
authors: Notario Muñoz
authors: Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
authors: Marta
authors: M
authors: Rupérez Lucas
authors: Department of Pediatrics and Neonatology, Hospital Universitario Severo Ochoa, Leganes, Comunidad de Madrid, Spain.
authors: Adelaida
authors: A
authors: Fernández Rincón
authors: Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
authors: Olga
authors: O
authors: Patiño Hernández
authors: Department of Pediatrics and Neonatology, Hospital Universitario Severo Ochoa, Leganes, Comunidad de Madrid, Spain.
authors: Cristina
authors: C
authors: Calvo Rey
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D001988:Bronchiolitis / Q000188:drug therapy* / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D012462:Saline Solution, Hypertonic