Using a high-flow nasal cannula provided superior results to low-flow oxygen delivery in moderate to severe bronchiolitis.
OBJECTIVE
An observational study was carried out on infants with moderate to severe bronchiolitis to compare the clinical outcomes following treatment with a high-flow nasal cannula (HFNC) or standard low-flow oxygen.


METHODS
We enrolled subjects below 12 months of age who were affected by their first bronchiolitis episode. Non-formal randomisation, based on HFNC availability, was used to assign subjects to either the HFNC or standard oxygen groups. Respiratory rate, respiratory effort and the ability to feed were compared between the two groups at enrolment and at regular time points. The oxygen requirements and the length of hospital stay were also analysed.


RESULTS
Overall, 36 of the 40 enrolled infants completed the study: 18 treated with HFNC (mean age 3.2 months, range 1.2-5.4 months) and 18 with low-flow oxygen delivery (mean age 3.6 months, range 1.3-5.0 months). Improvements in the respiratory rate, respiratory effort and ability to feed were significantly faster in the HFNC group than the low-flow oxygen group. The HNFC group needed oxygen supplementation for two days less than the other group and hospital stays were three days shorter.


CONCLUSIONS
HFNC provided superior clinical outcomes for infants under 12 months with moderate-to-severe bronchiolitis compared to low-flow oxygen.
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Gregorio P
GP
Milani
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Anna M
AM
Plebani
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Elisa
E
Arturi
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Danila
D
Brusa
Paediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Susanna
S
Esposito
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Laura
L
Dell'Era
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Emanuela A
EA
Laicini
Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Dario
D
Consonni
Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Carlo
C
Agostoni
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Emilio F
EF
Fossali
D001988:Bronchiolitis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods*; D056152:Respiratory Rate
D010100:Oxygen
Bronchiolitis; High-flow nasal cannula; Low-flow oxygen delivery; Non-invasive ventilation; Respiratory infection