Original Article

European Journal of Pediatrics

, Volume 173, Issue 7, pp 953-958

Comparison of a high-flow humidified nasal cannula to nasal continuous positive airway pressure in children with acute bronchiolitis: experience in a pediatric intensive care unit

  • Prune MetgeAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University
  • , Céline GrimaldiAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University
  • , Sophie HassidAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University
  • , Laurent ThomachotAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University
  • , Anderson LoundouAffiliated withDepartment of Public Health, EA 3279 Research Unit, University Hospital, Aix-Marseille University
  • , Claude MartinAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University
  • , Fabrice MichelAffiliated withPediatric and Neonatal Intensive Care Unit, APHM, North Hospital, Aix-Marseille University Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

The objective of the current study is to compare the use of a nasal continuous positive airway pressure (nCPAP) to a high-flow humidified nasal cannula (HFNC) in infants with acute bronchiolitis, who were admitted to a pediatric intensive care unit (PICU) during two consecutive seasons. We retrospectively reviewed the medical records of all infants admitted to a PICU at a tertiary care French hospital during the bronchiolitis seasons of 2010/11 and 2011/12. Infants admitted to the PICU, who required noninvasive respiratory support, were included. The first noninvasive respiratory support modality was nCPAP during the 2010/11 season, while HFNC was used during the 2011/2012 season. We compared the length of stay (LOS) in the PICU; the daily measure of PCO2 and pH; and the mean of the five higher values of heart rate (HR), respiratory rate (RR), FiO2, and SpO2 each day, during the first 5 days. Thirty-four children met the inclusion criteria: 19 during the first period (nCPAP group) and 15 during the second period (HFNC group). Parameters such as LOS in PICU and oxygenation were similar in the two groups. Oxygen weaning occurred during the same time for the two groups. There were no differences between the two groups for RR, HR, FiO2, and CO2 evolution. HFNC therapy failed in three patients, two of whom required invasive mechanical ventilation, versus one in the nCPAP group. Conclusion: We did not find a difference between HFNC and nCPAP in the management of severe bronchiolitis in our PICU. Larger prospective studies are required to confirm these findings.

Keywords

Acute viral bronchiolitis Respiratory distress Nasal CPAP High-flow nasal cannula