Nasal Continuous Positive Airway Pressure in Bronchiolitis: A Randomized Controlled Trial

Lal, Sandeep Narayan; Kaur, Jaspreet; Anthwal, Pooja; Goyal, Kanika; Bahl, Pinky; Puliyel, Jacob

doi:10.1007/s13312-018-1222-7

Cited by 26 publications

(41 citation statements)

References 12 publications

(16 reference statements)

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“…Our final screening revealed that 9 eligible papers underwent qualitative analysis (a total of 9 studies). [30][31][32][33][34][35][36][37][38] Only 7 studies were included for quantitative analysis consisting of 6 retrospective studies and 1 randomized controlled trial. Figure 1 shows the PRISMA flow chart 25 to illustrate the study selection process.…”

Section: Literature Search and Selectionmentioning

confidence: 99%

Effectiveness of Non-invasive Ventilation in Treating Infants Aged 1 to 12 Months with Severe Bronchiolitis: A Systematic Review and Meta-analysis

2021

Acta Med Philipp

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Objective. This study was done to determine the effectiveness of non-invasive ventilation (NIV) in treating infants aged 1 to 12 months with severe bronchiolitis based on a systematic review of literature and meta-analysis of quantitative results. Methods.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram for identification, screening, and identification of eligible studies. Five databases (PubMed, Herdin, Cochrane Library, Google Scholar, and Science Direct) were searched for relevant studies involving the use of NIV among children with severe bronchiolitis. Included studies were assessed for quality and risk of bias.Results. There were 9 included eligible studies. The length of hospital stay and duration of respiratory support were significantly lower with the use of NIV compared with IMV (invasive mechanical ventilation) based on pooled standard mean difference (SMD) estimates; however, there was high statistical heterogeneity in the included studies. This can be attributed to differences in the mode of intervention used among studies, patient-specific factors, and viral virulence. Significant improvements in heart rate, oxygen saturation, and tCO 2 were seen in the included studies. One study showed statistically significant differences in changes in respiratory rate and improvement in respiratory status based on two bronchiolitis severity scores among infants placed on NIV. Conclusion.Fair to good-quality evidence from included studies reveals that there is a significant reduction in length of hospital stay, duration of respiratory support, and improvements in respiratory parameters among infants who received NIV for severe bronchiolitis. Larger, well-designed clinical trials on the use of NIV among resource-limited settings wherein it may offer valuable clinical utility, are recommended for future study.

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Section: Literature Search and Selectionmentioning

confidence: 99%

Effectiveness of Non-invasive Ventilation in Treating Infants Aged 1 to 12 Months with Severe Bronchiolitis: A Systematic Review and Meta-analysis

2021

Acta Med Philipp

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“…A total of 7 trials were identified describing important physiological findings. There were several physiological studies either using a cross over or a randomised controlled trial design (8,(37)(38)(39)(40)(41). All of these physiological studies, with some being reported as early as the 1990's, demonstrated significant improvement in either respiratory mechanics, work of breathing or gas exchange with improved CO2 clearance or oxygenation.…”

Section: Physiological Studiesmentioning

confidence: 99%

Respiratory support for infants with bronchiolitis, a narrative review of the literature

Franklin

Schibler

2019

Paediatric Respiratory Reviews

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Bronchiolitis is a common viral disease that significantly affects infants less than 12 months of age. The purpose of this review is to present a review of the current knowledge of the uses of respiratory support in the management of infants with bronchiolitis presenting to hospital. We electronically searched MEDLINE, Cochrane, CINAHL and EMBASE (inception to 25th March 2018), to manually search for clinical trials that address the management strategies for respiratory support of infants with bronchiolitis. We identified 120 papers who met the inclusion criteria, of which 33 papers were relevant for this review with only nine randomised controlled trials. This review demonstrated that noninvasive respiratory support reduced the need for escalation of therapy, particularly the proportion of intubations required for infants with bronchiolitis. Additionally, clear economic benefits have been demonstrated when non-invasive ventilation has been used. The potential early use of non-invasive respiratory supports such as nasal high flow therapy and non-invasive ventilation may have an impact on health care costs and reduction in ICU admissions and intubation rates. High-grade evidence demonstrates safety and quality of high flow therapy in general ward settings.

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“…In China, respiratory departments have demonstrated wide application and good clinical efficacy of nCPAP; however, some key problems have not been solved. There is no uniform standard for setting and titrating positive endexpiratory pressure (PEEP) level, which is paramount to the effectiveness of the treatment (4,5). This prospective study between December 2018 and February 2019, compared the clinical efficacy of nCPAP at various PEEP levels in the treatment of severe bronchiolitis; changes in the degree of airway obstruction and respiratory mechanics parameters were also assessed.…”

Section: Introductionmentioning

confidence: 99%

Optimal level of positive end-expiratory pressure during nasal continuous airway pressure for severe bronchiolitis: a prospective study

Yin¹,

Li²,

Peng³

et al. 2021

Transl Pediatr

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Background: Nasal continuous positive airway pressure (nCPAP) has been increasingly applied in the pediatric setting. However, there is no uniform standard for setting and titrating positive end-expiratory pressure (PEEP) level, which is paramount to the effectiveness of the treatment. This study aimed to investigate the optimal parameters for nCPAP in the treatment of severe bronchiolitis based on clinical efficacy and pulmonary function parameters.Methods: A before-after prospective study was conducted with a total of 152 study subjects. These 152 hospitalized patients with severe bronchiolitis were treated and observed from December 2018 to February 2019. Comparisons were made between subjects for clinical symptoms, oxygenation improvement, correction of CO 2 retention, degree of airway obstruction and respiratory mechanics improvement between three different positive end-expiratory pressure levels (PEEP).Results: nCPAP could effectively improve the clinical manifestations, blood gas analysis, pulmonary function and respiratory muscle energy consumption. The m-WCAS score, PaCO 2 , TPTEF/TE, VPEF/ VE, respiratory system compliance (Crs) and resistance (Rrs) were significantly different at different PEEP levels (P<0.05). Although there were no hemodynamic changes at peep parameter levels in the three groups.Group 2 (PEEP: 6 cmH 2 O) had optimal clinical effects, and improvement in airway obstruction and respiratory mechanics compared with the group 1 (PEEP: 4 cmH 2 O) and the group 3 (PEEP: 7 cmH 2 O).Conclusions: PEEP of 6 cmH 2 O via nCPAP is considered as the optimal level in the treatment of infants with severe bronchiolitis.

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Nasal Continuous Positive Airway Pressure in Bronchiolitis: A Randomized Controlled Trial

Abstract: nCPAP helped reduce respiratory distress significantly compared to standard care.

Cited by 26 publications

References 12 publications

Effectiveness of Non-invasive Ventilation in Treating Infants Aged 1 to 12 Months with Severe Bronchiolitis: A Systematic Review and Meta-analysis

Effectiveness of Non-invasive Ventilation in Treating Infants Aged 1 to 12 Months with Severe Bronchiolitis: A Systematic Review and Meta-analysis

Respiratory support for infants with bronchiolitis, a narrative review of the literature

Optimal level of positive end-expiratory pressure during nasal continuous airway pressure for severe bronchiolitis: a prospective study

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