High-flow Oxygen for Bronchiolitis

Bronchiolitis is the most common lung infection in infants. Usual treatment involves management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but its efficacy and safety has not been demonstrated in rigorous trials. 

We examined whether HFWHO:

• shortened time to weaning off oxygen
• reduced treatment failure, Intensive Care Unit (ICU) transfers and length of stay
• was acceptable to parents. 

A pragmatic randomised controlled trial was conducted with infants with moderate bronchiolitis. No significant difference was detected in time to weaning off oxygen. There was a significant difference in favour of HFWHO in number of treatment failures, and time to treatment failure, length of stay and ICU presentations, and strong parental acceptability. No oxygen-related adverse events occurred.​