European Journal of Pediatrics

, Volume 177, Issue 8, pp 1299–1307 | Cite as

Using a high-flow nasal cannula provides superior results to OxyMask delivery in moderate to severe bronchiolitis: a randomized controlled study

  • Ayse Betul ErgulEmail author
  • Emrah Calıskan
  • Hasan Samsa
  • Ikbal Gokcek
  • Ali Kaya
  • Gozde Erturk Zararsiz
  • Yasemin Altuner Torun
Original Article


The effectiveness of using a face mask with a small diffuser for oxygen delivery (OxyMask) was compared to use of a high-flow nasal cannula (HFNC) in patients with moderate or severe bronchiolitis.

The study population in this open, phase 4, randomized controlled trial consisted of 60 patients aged 1–24 months diagnosed with moderate or severe bronchiolitis and admitted to an intensive care unit (ICU) for oxygen therapy. The patients were randomized into two groups according to the method of oxygen delivery: a diffuser mask group and an HFNC group.

There were seven failures in the mask group and none in the HFNC group. The survival probability differed significantly between the two treatment methods (p = 0.009).

Time to weaning off oxygen therapy was 56 h in the HFNC group and 96 h in the mask group (p < 0.001).

Conclusion: HFNC use decreased the treatment failure rate and the duration of both oxygen therapy and ICU treatment compared to the diffuser mask, which implies that an HFNC should be the first choice for treating patients admitted to the ICU with severe bronchiolitis.

What is known:

A high-flow nasal cannula (HFNC) does not significantly reduce the time on oxygen compared to standard therapy in children with moderate to severe bronchiolitis. Observational studies show that, since the introduction of HFNC, fewer children with bronchiolitis need intubation. For children with moderate to severe bronchiolitis there is no proof of its benefit.

What Is New:

In children with moderate to severe bronchiolitis, HFNC provides faster and more effective improvement than can be achieved with a diffuser mask.


Bronchiolitis Diffuser mask High-flow nasal oxygen OxyMask Pediatric intensive care unit 



Fraction of inspired oxygen


High-flow nasal cannula


Intensive care unit


Partial pressure of carbon dioxide


Oxygen saturation



The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see:

Authors’ contributions

Conception: ABE; Design: ABE, EC; Supervision: ABE; Materials: ABE, IG, HS, YAT, AK; Data collection and processing: ABE, EC; Analysis and/or interpretation: ABE, GZ, EC; Literature review: ABE, EC; Writer: ABE; Critical review: ABE.

Compliance with ethical standards

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all participants included in the study.

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Consent was obtained from all individual parents and participants included in the study

Supplementary material

431_2018_3191_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 21.3 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric Intensive Care Unit, University of Health SciencesKayseri Training and Research HospitalKayseriTurkey
  2. 2.Department of Pediatrics, University of Health SciencesKayseri Training and Research HospitalKayseriTurkey
  3. 3.Department of BiostatisticsErciyes University School of MedicineKayseriTurkey
  4. 4.Department of Pediatric Hematology, University of Health SciencesKayseri Training and Research HospitalKayseriTurkey

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