Abstract
Introduction: In bronchiolitis, treatment is primarily supportive and aimed at maintaining adequate oxygenation and hydration. High-flow nasal cannula (HFNC) therapy provides a heated and humidified blend of air and oxygen and delivers higher gas flow rates than standard nasal cannulae. Objective: To determine whether the availability and use of high-flow nasal cannula (HFNC) therapy at a general pediatric ward is associated with a decrease in intubation rate for infants admitted with bronchiolitis. Methods: A retrospective chart review study was conducted on infants with bronchiolitis admitted to the general pediatric ward of center A (HFNC available) and center B (HFNC not available) between July 2011 and June 2014. Results: A total of 403 patients (of 405 bronchiolitis episodes) were included of which 63 patients in center A received HFNC therapy. HFNC was well tolerated by infants. In center A 6.8% (15/220) of the infants required intubation as compared to 12.4% (23/185) of the infants in center B (p value = 0.05). After adjusting for age and weight in a logistic regression model, a decrease of 47% in odds of intubation persisted when HFNC was available (Odds Ratio = 0.53, 95% confidence interval = 0.27-1.07, p value = 0.08). No complications of HFNC use were reported and the mortality was zero. Conclusion: Our results suggest that the use of high-flow nasal cannula therapy at a general pediatric ward is associated with a decrease in intubation rate for infants admitted with bronchiolitis. HFNC therapy is a feasible and safe device to use on a general pediatric ward.
Published Version
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