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J Pediatr Intensive Care 2020; 09(04): 248-255
DOI: 10.1055/s-0040-1709656
Original Article

High-Flow Nasal Cannula versus Continuous Positive Airway Pressure in Critical Bronchiolitis: A Randomized Controlled Pilot

Regina Grigolli Cesar
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Bibiane Ramos Pinheiro Bispo 
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Priscilla Helena Costa Alves Felix 
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Maria Carolina Caparica Modolo
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Andreia Aparecida Freitas Souza
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Nelson K. Horigoshi 
1   Unidade de Terapia Intensiva, Hospital Infantil Sabará e Instituto PENSI, São Paulo, Brazil
,
Alexandre T. Rotta 
2   Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, United States
› Author Affiliations Funding This study was supported by Hospital Infantil Sabará and Instituto PENSI. High-flow devices and circuits were provided by Vapotherm, Inc. at no cost to the investigators. Vapotherm was not involved in the planning, execution, data analysis, data interpretation, or writing of the manuscript, and was not privy to its results.
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Abstract

We conducted a randomized controlled pilot study in infants with critical bronchiolitis (n = 63) comparing high-flow nasal cannula (HFNC, n = 35) to continuous positive airway pressure (CPAP, n = 28). The primary outcome was treatment failure, defined as the need for bilevel positive pressure ventilation or endotracheal intubation. Treatment failure occurred in 10 patients (35.7%) in the CPAP group and 13 patients (37.1%) in the HFNC group (p = 0.88). Pediatric intensive care unit length of stay was similar between the CPAP and HFNC groups (5 [4–7] days and 5 [4–8] days, p = 0.46, respectively). In this pilot study, treatment with HFNC resulted in a rate of treatment failure similar to CPAP.

Keywords

bronchiolitis - high-flow nasal cannula - continuous positive airway pressure - respiratory syncytial virus - acute respiratory failure - infants


Publication History

Received: 03 February 2020

Accepted: 10 March 2020

Article published online:
17 April 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

Letter to this article:

Truth Has Nothing to Do with the Conclusion, and Everything to Do with the MethodologyJ Pediatr Intensive Care 2021; 10(01): 083-084
DOI: 10.1055/s-0040-1713612

Letter to this article:

Response from the AuthorsJ Pediatr Intensive Care 2021; 10(03): 240-242
DOI: 10.1055/s-0040-1713611

 

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