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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0000000000000112
Online Clinical Investigations

Physiologic Effect of High-Flow Nasal Cannula in Infants With Bronchiolitis

Hough, Judith L PhD1,2,3; Pham, Trang M. T. BEng1; Schibler, Andreas MD, FCICM1

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Objective: To assess the effect of delivering high-flow nasal cannula flow on end-expiratory lung volume, continuous distending pressure, and regional ventilation distribution in infants less than 12 months old with bronchiolitis.

Design: Prospective observational clinical study.

Setting: Nineteen bed medical and surgical PICU.

Patients: Thirteen infants with bronchiolitis on high-flow nasal therapy.

Interventions: The study infants were measured on a flow rate applied at 2 and 8 L/min through the high-flow nasal cannula system.

Measurements and Results: Ventilation distribution was measured with regional electrical impedance amplitudes and end-expiratory lung volume using electrical impedance tomography. Changes in continuous distending pressure were measured from the esophagus via the nasogastric tube. Physiological variables were also recorded. High-flow nasal cannula delivered at 8 L/min resulted in significant increases in global and anterior end-expiratory lung volume (p < 0.01) and improvements in the physiological variables of respiratory rate, SpO2, and FIO2 when compared with flows of 2 L/min.

Conclusion: In infants with bronchiolitis, high-flow nasal cannula oxygen/air delivered at 8 L/min resulted in increases in end-expiratory lung volume and improved respiratory rate, FIO2, and SpO2.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies


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