Physiologic effect of high-flow nasal cannula in infants with bronchiolitis. (Ruth)

Hough JL, Pham TM, Schibler A. Physiologic effect of high-flow nasal cannula
in infants with bronchiolitis. Pediatr Crit Care Med. 2014 Jun;15(5):e214-9.

Full-text for Children’s and Emory users.

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.

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