High-flow oxygen in bronchiolitis

It’s autumn in the northern hemisphere, and the bronchiolitis season is upon us. In recent years, high-flow warm humidified oxygen (HFWHO) has become more popular, through use of devices such as Optiflow and Vapotherm. Its use on children’s wards has crept across from the neonatal unit, where there is good evidence of its effectiveness in neonatal lung disease. It is surprising therefore to find that, until now, there have been no randomised controlled trials (RCTs) in bronchiolitis.

A team from Newcastle, New South Wales, Australia, set out to rectify this (Kepreotes E et al. Lancet 2017. http://ift.tt/2gpqBs0). In a single-centre RCT from 2012 to 2015, they recruited 200 children aged 0–24 months. Each had been admitted with a clinical diagnosis of bronchiolitis requiring supplemental oxygen. They were randomised to receive either standard care (cold, dry oxygen up to 2 L/min through nasal cannulae), or HFWHO through an Optiflow device (up to 1 L/kg/min,...

from ADC Online First http://ift.tt/2vsQpKD