Physiologic effect of high-flow nasal cannula in infants with bronchiolitis.
OBJECTIVE
To assess the effect of delivering high-flow nasal cannula flow on end-expiratory lung volume, continuous distending pressure, and regional ventilation distribution in infants less than 12 months old with bronchiolitis.


METHODS
Prospective observational clinical study.


METHODS
Nineteen bed medical and surgical PICU.


METHODS
Thirteen infants with bronchiolitis on high-flow nasal therapy.


METHODS
The study infants were measured on a flow rate applied at 2 and 8 L/min through the high-flow nasal cannula system.


RESULTS
Ventilation distribution was measured with regional electrical impedance amplitudes and end-expiratory lung volume using electrical impedance tomography. Changes in continuous distending pressure were measured from the esophagus via the nasogastric tube. Physiological variables were also recorded. High-flow nasal cannula delivered at 8 L/min resulted in significant increases in global and anterior end-expiratory lung volume (p < 0.01) and improvements in the physiological variables of respiratory rate, SpO2, and FIO2 when compared with flows of 2 L/min.


CONCLUSIONS
In infants with bronchiolitis, high-flow nasal cannula oxygen/air delivered at 8 L/min resulted in increases in end-expiratory lung volume and improved respiratory rate, FIO2, and SpO2.
1Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children's Hospital, South Brisbane, QLD, Australia. 2School of Physiotherapy, Australian Catholic University, Banyo, QLD, Australia. 3Critical Care of the Newborn Program, Mater Research, South Brisbane, QLD, Australia.
Judith L
JL
Hough
Trang M T
TM
Pham
Andreas
A
Schibler
D000399:Air Pressure; D001988:Bronchiolitis / Q000503:physiopathology / Q000628:therapy*; D045422:Continuous Positive Airway Pressure; D017097:Electric Impedance; D004947:Esophagus; D005260:Female; D006801:Humans; D007223:Infant; D008176:Lung Volume Measurements; D008297:Male; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011446:Prospective Studies; D012123:Pulmonary Ventilation / Q000502:physiology*; D056152:Respiratory Rate
D010100:Oxygen