부산대학교 도서관

PURPOSE OF STUDY: High flow oxygen (HFO) has been used more commonly as supportive treatment of paediatric patients with bronchiolitis. The objective of this study is to determine if HFO use on the patients admitted to the inpatient wards leads to reduction in paediatric intensive care unit (PICU) admission and/or intubation rates, as well as hospital length of stay (LOS). METHODS USED: We performed a literature based review through PubMed and Google Scholar databases using key terms such as: Bronchiolitis, High-Flow Oxygen, Paediatric, High-Flow Nasal Cannula (HFNC). Only studies with infants<24 months of age with bronchiolitis that included a control group with conventional oxygen were included. Studies that included patients who were directly admitted into the PICU, used heliox, or continuous positive airway pressure (CPAP) were excluded. SUMMARY OF RESULTS: Out of the 23 articles found, 4 satisfied our inclusion criteria (see table 1 below). Many articles were excluded because they lacked controls or patients were admitted directly to the PICU. Patients hospitalised on the wards who were on HFNC had lower PICU admission and/or intubation rates in 1 of the 4 studies. Hospital LOS was lower in the HFNC group in 2 of the 4 studies. The studies were limited in controlling for severity of disease or using retrospective controls. Also, the protocols for using HFNC were variable among different studies. CONCLUSIONS: Our review revealed conflicting results in regards to usefulness of HFNC in decreasing hospital stay, intubation and PICU admission rates in children less than 2 years of age with bronchiolitis who are admitted to the paediatric ward. Larger prospective controlled studies with standardised HFO protocols are needed to confirm efficacy of HFNC in treatment of paediatric patients with bronchiolitis.(Table is included in full-text article.)