Trattare la bronchiolite con nCPAP nelle Pediatrie per “proteggere” le Terapie Intensive pediatriche?

Abstract

Respiratory support with oxygen (O2 ) is the recognized mainstay of treatment in acute bronchiolitis. The methods of administration include - in addition to low flow O2 - also heated and humidified high flow O2 (HFNC) and CPAP, according to an increasing stratification of severity and respiratory effort. The transition from HFNC to CPAP requires, in most cases, the transfer of the child to an intensive care unit (PICU). The particular epidemic trend of bronchiolitis in the post-pandemic years and the concrete risk of care overload for PICUs led us to consider the use of nCPAP in the general paediatric ward as an alternative to transfer to intensive care, aiming to reduce the pressure on the PICU and the consequent discomfort and psychological load for children and their families. We describe our preliminary experience - which allowed us to avoid about 80% of transfers to PICU for bronchiolitis - discussing some clinical issues and possible organizational developments.