In infants with all-cause respiratory distress presenting in the PED, triage respiratory rate greater than 90th percentile for age, initial venous PCO2 greater than 50 mm Hg, and initial venous pH less than 7.30 were associated with failure of HFNC therapy. A diagnosis of acute bronchiolitis was protective with respect to intubation following HFNC. This finding may help guide clinicians who use HFNC by identifying a patient population at higher risk of failing therapy.

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