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Humidified high‐flow nasal cannula oxygen in bronchiolitis reduces need for invasive ventilation but not intensive care admission

2017; Wiley; Volume: 53; Issue: 9 Linguagem: Inglês

10.1111/jpc.13564

1440-1754

Chong Tien Goh, L. Kirby, David Schell, Jonathan R. Egan,

Pneumonia and Respiratory Infections

Aim To describe the changes to paediatric intensive care unit (PICU) admission patterns and ventilation requirements for children with bronchiolitis following the introduction of humidified high‐flow nasal cannula oxygen outside the PICU. Methods Retrospective study comparing patients <24 months of age with a discharge diagnosis of bronchiolitis admitted to the PICU. A comparison was made between those before humidified high‐flow nasal cannula oxygen use (year 2008) to those immediately following the introduction of humidified high‐flow nasal cannula oxygen use (year 2011) and those following further consolidation of humidified high‐flow nasal cannula oxygen use outside the PICU (year 2013). Results Humidified high‐flow nasal cannula oxygen use up to 1 L/kg/min in the hospital did not reduce PICU admission. Intubation rates were reduced from 22.2% in 2008 to 7.8% in 2013. There was a non‐significant trend towards decreased length of stay in the PICU while hospital length of stay showed a significant decrease following the introduction of humidified high‐flow nasal cannula oxygen. Age <6 months and respiratory syncytial virus bronchiolitis were associated with an increased chance of failing humidified high‐flow nasal cannula oxygen therapy. Conclusion Humidified high‐flow nasal cannula oxygen utilised outside of the PICU in our institution for children with bronchiolitis did not reduce admission rates or length of stay to the PICU but was associated with a decreasing need for invasive ventilation and reduced hospital length of stay.