Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study

Milési, Christophe; Baleine, Julien; Matecki, Stéfan; Durand, Sabine; Combes, Clémentine; Novais, Aline Rideau Batista; Cambonie, Gilles

doi:10.1007/s00134-013-2879-y

Cited by 188 publications

(196 citation statements)

References 28 publications

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“…In a prospective observational study, KRIVEC et al [120] enrolled 39 children f24 months of age with acute viral bronchiolitis and showed that HFNC effectively improved physiological respiration and gas exchange variables. These results are in line with other recent clinical trials, which demonstrated improved breathing patterns and rapid respiratory muscle uploading after HFNC treatment for viral bronchiolitis in infants [121].…”

Section: Paediatric Intensive Caresupporting

confidence: 92%

Paediatrics in Barcelona

et al. 2014

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Section: Paediatric Intensive Caresupporting

confidence: 92%

Paediatrics in Barcelona

et al. 2014

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“…126 There is evidence that high-flow nasal cannula improves physiologic measures of respiratory effort and can generate continuous positive airway pressure in bronchiolitis. [127][128][129][130] Clinical evidence suggests it reduces work of breathing 131,132 and may decrease need for intubation, [133][134][135][136] although studies are generally retrospective and small. The therapy has been studied in the ED 136,137 and the general inpatient setting, 134,138 as well as the ICU.…”

Section: Action Statement Profile Kas 6bmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,421

1,654

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This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows:

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“…7 Flow rates of ≥6 L/min were associated with positive pharyngeal pressures throughout the respiratory cycle. Another study in infants with bronchiolitis found a linear association between increasing HHHFNC therapy flow rates and nasopharyngeal pressure, with a reduction in the rate of increase in pressure with flow rates >6 L/min.…”

Section: Mechanisms Of Action Of Hhhfnc Therapymentioning

confidence: 97%

Heated humidified high-flow nasal cannula therapy in children

2014

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Heated humidified high-flow nasal cannula therapy (HHHFNC) was originally described as a mode of respiratory support in premature neonates and is now increasingly used in the management of acute respiratory failure in older infants and children. Heating and humidification of gas mixtures allow comfortable delivery of flow rates that match or exceed the patient's inspiratory flow rate. Emerging evidence from observational studies suggests that the use of HHHFNC therapy may be associated with reduced work of breathing, improved ventilation efficiency and a decreased need for intubation in children with respiratory insufficiency. There are several proposed mechanisms of action, and the potential for provision of unpredictable positive distending pressure has caused concern. Randomised controlled trial evidence comparing clinical outcomes with those achieved using other forms of respiratory support is, however, awaited. We review the proposed mechanisms of actions, indications, advantages and complications of HHHFNC therapy in children and describe our approach to its use in the paediatric ward environment.

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Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study

Abstract: HFNC with a flow rate equal to or above 2 L/kg/min generated a clinically relevant PP, with improved breathing pattern and rapid unloading of respiratory muscles, in young infants with acute RSV bronchiolitis.

Cited by 188 publications

References 28 publications

Paediatrics in Barcelona

Paediatrics in Barcelona

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Heated humidified high-flow nasal cannula therapy in children

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