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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

Pediatric Critical Care Medicine: June 2014 - Volume 15 - Issue 5 - p e214–e219
doi: 10.1097/PCC.0000000000000112
Online Clinical Investigations

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.

1Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children’s Hospital, South Brisbane, QLD, Australia.

2School of Physiotherapy, Australian Catholic University, Banyo, QLD, Australia.

3Critical Care of the Newborn Program, Mater Research, South Brisbane, QLD, Australia.

Dr. Schibler’s institution received grant support from Fisher & Paykel Healthcare. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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