Frontiers in Pediatrics (Oct 2019)
Nasal High Flow in Room Air for Hypoxemic Bronchiolitis Infants
- Donna Franklin,
- Donna Franklin,
- Donna Franklin,
- Donna Franklin,
- Donna Franklin,
- Franz E. Babl,
- Franz E. Babl,
- Franz E. Babl,
- Franz E. Babl,
- Kristen Gibbons,
- Kristen Gibbons,
- Trang M. T. Pham,
- Trang M. T. Pham,
- Nadia Hasan,
- Luregn J. Schlapbach,
- Luregn J. Schlapbach,
- Luregn J. Schlapbach,
- Ed Oakley,
- Ed Oakley,
- Ed Oakley,
- Ed Oakley,
- Simon Craig,
- Simon Craig,
- Simon Craig,
- Jeremy Furyk,
- Jeremy Furyk,
- Jeremy Furyk,
- Jocelyn Neutze,
- Jocelyn Neutze,
- Jocelyn Neutze,
- Susan Moloney,
- Susan Moloney,
- Susan Moloney,
- John Gavranich,
- Prasanna Shirkhedkar,
- Vishal Kapoor,
- Vishal Kapoor,
- Simon Grew,
- John F. Fraser,
- John F. Fraser,
- Stuart Dalziel,
- Stuart Dalziel,
- Stuart Dalziel,
- Andreas Schibler,
- Andreas Schibler,
- Andreas Schibler,
- Andreas Schibler,
- PARIS and PREDICT
Affiliations
- Donna Franklin
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Donna Franklin
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Donna Franklin
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Donna Franklin
- Critical Care Research Group, Adult Intensive Care Service, The Prince Charles Hospital, Brisbane, QLD, Australia
- Donna Franklin
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Franz E. Babl
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Franz E. Babl
- Royal Children's Hospital, Emergency Department, Melbourne, VIC, Australia
- Franz E. Babl
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Franz E. Babl
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- Kristen Gibbons
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Kristen Gibbons
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Trang M. T. Pham
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Trang M. T. Pham
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Nadia Hasan
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Luregn J. Schlapbach
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Luregn J. Schlapbach
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Luregn J. Schlapbach
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Ed Oakley
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Ed Oakley
- Royal Children's Hospital, Emergency Department, Melbourne, VIC, Australia
- Ed Oakley
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Ed Oakley
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- Simon Craig
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Simon Craig
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Simon Craig
- 0Monash Medical Centre, Emergency Department, Melbourne, VIC, Australia
- Jeremy Furyk
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Jeremy Furyk
- 1College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Jeremy Furyk
- 2The Townsville Hospital, Emergency Department, Townsville, QLD, Australia
- Jocelyn Neutze
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Jocelyn Neutze
- 3KidzFirst Middlemore Hospital, Auckland, New Zealand
- Jocelyn Neutze
- 4University of Auckland, Auckland, New Zealand
- Susan Moloney
- 5Department of Paediatrics, Gold Coast University Hospital, Southport, QLD, Australia
- Susan Moloney
- 6School of Medicine, Griffith University, Gold Coast, QLD, Australia
- Susan Moloney
- 7Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- John Gavranich
- 8Paediatric Department, Ipswich General Hospital, Ipswich, QLD, Australia
- Prasanna Shirkhedkar
- 9Paediatric Department, Caboolture Hospital, Caboolture, QLD, Australia
- Vishal Kapoor
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Vishal Kapoor
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Simon Grew
- 0Paediatric Department, Redcliffe Hospital, Redcliffe, QLD, Australia
- John F. Fraser
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- John F. Fraser
- Critical Care Research Group, Adult Intensive Care Service, The Prince Charles Hospital, Brisbane, QLD, Australia
- Stuart Dalziel
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- Stuart Dalziel
- 1Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand
- Stuart Dalziel
- 2Liggins Institute, University of Auckland, Auckland, New Zealand
- Andreas Schibler
- Paediatric Critical Care Research Group, Queensland Children's Hospital, The University of Queensland, Brisbane, QLD, Australia
- Andreas Schibler
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Andreas Schibler
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Andreas Schibler
- Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, VIC, Australia
- PARIS and PREDICT
- DOI
- https://doi.org/10.3389/fped.2019.00426
- Journal volume & issue
-
Vol. 7
Abstract
Background: Bronchiolitis is the most common reason for hospital admission in infants, with one third requiring oxygen therapy due to hypoxemia. It is unknown what proportion of hypoxemic infants with bronchiolitis can be managed with nasal high-flow in room air and their resulting outcomes.Objectives and Settings: To assess the effect of nasal high-flow in room air in a subgroup of infants with bronchiolitis allocated to high-flow therapy in a recent multicenter randomized controlled trial.Patients and Interventions: Infants allocated to the high-flow arm of the trial were initially treated with room air high-flow if saturations were ≥85%. Subsequently, if oxygen saturations did not increase to ≥92%, oxygen was added and FiO2 was titrated to increase the oxygen saturations. In this planned sub-study, infants treated during their entire hospital stay with high-flow room air only were compared to infants receiving either standard-oxygen or high-flow with oxygen. Baseline characteristics, hospital length of stay and length of oxygen therapy were compared.Findings: In the per protocol analysis 64 (10%) of 630 infants commenced on high-flow room air remained in room air only during the entire stay in hospital. These infants on high-flow room air were on average older and presented with moderate hypoxemia at presentation to hospital. Their length of respiratory support and length of stay was also significantly shorter. No pre-enrolment factors could be identified in a multivariable analysis.Conclusions: In a small sub-group of hypoxemic infants with bronchiolitis hypoxemia can be reversed with the application of high-flow in room air only.Trial registration: ACTRN12615001305516
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