High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial

Vahlkvist, Signe; Jürgensen, Louise; Cour, Amalie la; Markoew, S.; Petersen, Thomas Houmann; Kofoed, Poul Erik

doi:10.1007/s00431-019-03533-2

Cited by 48 publications

(38 citation statements)

References 14 publications

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“…Vahlkvist et al also reported that no differences were observed in improvement of respiratory rate or PaCO2 between the HFNC group and the CPAP group in infants with bronchiolitis. Treatment failure was rare in both groups, and there was no significant difference in the length of hospitalization or treatment duration (10).…”

Section: Discussionmentioning

confidence: 77%

“…It can regulate the oxygen flow and concentration, and it provides excellent humidification (7)(8)(9) and has some CPAP effect. In recent years, a few large sample-sized prospective clinical studies and meta-analysis have suggested that HFNC has a positive effect on oxygenation improvement, decreased work of breathing, intubation rate reduction, and need for respiratory support after extubation (10). HFNC has been found to be better than standard oxygen therapy, oxygen delivered through a standard nasal cannula, at a rate of up to 2 l of 100% oxygen per minute, to treat hypoxemia (11,12); furthermore, it has been shown to have better tolerance and less adverse reactions than CPAP (13).…”

Section: Introductionmentioning

confidence: 99%

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High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia

Liu

Cheng

et al. 2020

Front. Pediatr.

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Background: The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. Methods: Using a prospective randomized controlled study method, 84 patients with pneumonia and mild to moderate respiratory failure admitted to the Children's Hospital Affiliated to Chongqing Medical University from January 2018 to December 2019 were randomly divided into the HFNC group and the CPAP group. It was registered as a clinical trial at clinical trials.gov , registration number: ChiCTR2000030463. Results: The analyses included 84 patients. No differences were observed between the two groups in baseline demographic or physiological characteristics. Treatment failure necessitating intubation and transfer to the PICU was noted in six of 43 infants (14%) in the HFNC group, as compared with four of 41 infants (10%) in the CPAP group ( P > 0.05). There were no significant differences between the two groups in the duration of hospital stay, the duration of non-invasive respiratory support, and mortality. The 10 infants who experienced treatment failure had more severe hypoxemia with lower PaO2/FiO2 (HFNC 182 ± 11.5 and CPAP 172 ± 8.6). We found that both the HFNC group and the CPAP group showed significantly improved oxygenation and relief of respiratory distress after treatment. No differences were observed between the two groups in the development improvement of RR, PaO2, PaCO2, SpO2, and PH. Assessment of the occurrence of adverse events showed that the HFNC group had a lower level of nasal injury, a lower risk of abdominal distension, a lower intensity and frequency of sedation, and better tolerance. Conclusion: HFNC is an effective and safe initial respiratory support treatment in children <2 years with mild to moderate respiratory failure due to pneumonia, and the incidence of intubation and death is very low; concurrently, the comfort and tolerance of HFNC are better. To some extent, HFNC is a well-tolerated alternative to CPAP.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia

Liu

Cheng

et al. 2020

Front. Pediatr.

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“…On the other hand, there are possible therapies that might be addressed in a revision of the guideline in the near future, such as the use of high flow nasal cannula (HFNC). Since there are several clinical studies that found positive effects of HFNC in acute bronchiolitis [ 14 – 16 ], maybe this will motivate the principal investigators to publish the results of three recent studies that are yet unpublished (NCT02791711, NCT01498094, NCT02856165).…”

Section: Discussionmentioning

confidence: 99%

Decision-making in acute viral bronchiolitis: A universal guideline and a publication gap

Meyburg¹,

Ries²

2020

PLoS ONE

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Background Acute viral bronchiolitis is very common in infants and children up to 2 years. Some patients develop serious respiratory symptoms and need to be hospitalized. In 2014, the American Academy of Pediatrics (AAP) published a guideline on acute bronchiolitis which has gained global acceptance. We hypothesized that a publication gap, which is increasingly perceived in clinical medicine, might have also affected these universal recommendations.

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“…In addition, parents and carers favored HFNC because of the ability to feed and overall comfort (9,37). This aspect differs from CPAP, which is usually not well tolerated and interferes with patients' normal care, and is associated with a higher risk of air leak syndromes (38). In terms of HFNC's effectiveness, the evidence is still debatable, with studies for and against its use concerning CN or CPAP in children with moderate or severe bronchiolitis both existing.…”

Section: Discussionmentioning

confidence: 99%

The Cost‑utility of Early use of High-flow Nasal Cannula in Bronchiolitis

Rodriguez

Acuña‐Cordero

Rodríguez‐Martínez

2020

Preprint

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Background: High-flow nasal cannula (HFNC) oxygen is a non-invasive ventilation system that was introduced as an alternative to CPAP (continuous positive airway pressure), with a marked increase in its use in pediatric care settings .This study aimed to evaluate the cost-effectiveness of early use of HFNC compared to oxygen by nasal cannula in an infant with bronchiolitis in the emergency setting. Methods: A decision tree model was used to estimate the cost-effectiveness of HFNC compared with oxygen by nasal cannula (control strategy) in an infant with bronchiolitis in the emergency setting. Cost data were obtained from a retrospective study on bronchiolitis from tertiary centers in Rionegro, Colombia, while utilities were collected from the literature. Results:The QALYs per patient calculated in the base-case model were 0.9141 (95% CI 0.913- 0.915) in the HFNC and 0.9105 (95% CI 0.910- 0.911) in control group. The cost per patient was US$368 (95% CI US$ 323- 411) in HFNC and US$441 (95% CI US$ 384-498) per patient in the control group.Conclusions: HFNC in emergency settings was cost-effective for the hospital treatment of an infant with bronchiolitis

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High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial

Cited by 48 publications

References 14 publications

High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia

High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia

Decision-making in acute viral bronchiolitis: A universal guideline and a publication gap

The Cost‑utility of Early use of High-flow Nasal Cannula in Bronchiolitis

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