Download PDF
Am J Perinatol 2018; 35(06): 553-556
DOI: 10.1055/s-0038-1637765
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Respiratory Support in Bronchiolitis: Trial Evidence

Steve Cunningham
1   Department of Paediatric Respiratory Medicine, MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
25 April 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Acute viral lower respiratory tract infection is frequently associated with hypoxemia and respiratory distress, sometimes progressing to hypercarbia and respiratory failure. In recent years, trials have assessed the effects of oxygen supplementation and respiratory support with high-flow oxygen therapy. An oxygen saturation target of 90% is as safe and clinically effective as 94% in infants with bronchiolitis. Trials of high-flow humidified oxygen have demonstrated safety, but as yet poorly demarcated an appropriate place for use within the clinical course of the disease. Effective trials of continuous positive airway pressure are lacking and urgently required. The trials reported to date have highlighted the need for common outcomes in relation to treatment failure.

Keywords

bronchiolitis - oxygen - CPAP - high flow oxygen therapy
 

  • References

  • 1 Engel, Newns GH. Proliferative mural bronchiolitis. Arch Dis Child 1940; 15 (84) 219-229
    CrossrefPubMedSearch in Google Scholar
  • 2 Shi T, McAllister DA, O'Brien KL. , et al; RSV Global Epidemiology Network. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet 2017; 390 (10098): 946-958
    CrossrefPubMedSearch in Google Scholar
  • 3 Oakley E, Borland M, Neutze J. , et al; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Nasogastric hydration versus intravenous hydration for infants with bronchiolitis: a randomised trial. Lancet Respir Med 2013; 1 (02) 113-120
    CrossrefPubMedSearch in Google Scholar
  • 4 Duke T, Wandi F, Jonathan M. , et al. Improved oxygen systems for childhood pneumonia: a multihospital effectiveness study in Papua New Guinea. Lancet 2008; 372 (9646): 1328-1333
    CrossrefPubMedSearch in Google Scholar
  • 5 Quinonez RA, Coon ER, Schroeder AR, Moyer VA. When technology creates uncertainty: pulse oximetry and overdiagnosis of hypoxaemia in bronchiolitis. BMJ 2017; 358: j3850
    PubMedSearch in Google Scholar
  • 6 Bass JL, Corwin M, Gozal D. , et al. The effect of chronic or intermittent hypoxia on cognition in childhood: a review of the evidence. Pediatrics 2004; 114 (03) 805-816
    CrossrefPubMedSearch in Google Scholar
  • 7 Stenson BJ, Tarnow-Mordi WO, Darlow BA. , et al; BOOST II United Kingdom Collaborative Group; BOOST II Australia Collaborative Group; BOOST II New Zealand Collaborative Group. Oxygen saturation and outcomes in preterm infants. N Engl J Med 2013; 368 (22) 2094-2104
    PubMedSearch in Google Scholar
  • 8 Mansbach JM, Piedra PA, Stevenson MD. , et al; MARC-30 Investigators. Prospective multicenter study of children with bronchiolitis requiring mechanical ventilation. Pediatrics 2012; 130 (03) e492-e500
    CrossrefPubMedSearch in Google Scholar
  • 9 Cunningham S, Rodriguez A, Adams T. , et al; Bronchiolitis of Infancy Discharge Study (BIDS) group. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet 2015; 386 (9998): 1041-1048
    CrossrefPubMedSearch in Google Scholar
  • 10 Scottish Intercollegiate Guideline Network. Bronchiolitis in Children (SIGN 91). NHS Quality Improvement Scotland. 2006. Available at: http://www.sign.ac.uk/guidelines/fulltext/91/index.html . Accessed March 14, 2018
  • 11 American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics 2006; 118 (04) 1774-1793
    CrossrefPubMedSearch in Google Scholar
  • 12 Maitland K, Kiguli S, Opoka RO. , et al. Children's Oxygen Administration Strategies Trial (COAST): A randomised controlled trial of high flow versus oxygen versus control in African children with severe pneumonia. Wellcome Open Res 2017; 2: 100
    CrossrefPubMedSearch in Google Scholar
  • 13 Abernethy AP, McDonald CF, Frith PA. , et al. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet 2010; 376 (9743): 784-793
    CrossrefPubMedSearch in Google Scholar
  • 14 Thia LP, McKenzie SA, Blyth TP, Minasian CC, Kozlowska WJ, Carr SB. Randomised controlled trial of nasal continuous positive airways pressure (CPAP) in bronchiolitis. Arch Dis Child 2008; 93 (01) 45-47
    CrossrefPubMedSearch in Google Scholar
  • 15 Pedersen MB, Vahlkvist S. Comparison of CPAP and HFNC in management of bronchiolitis in infants and young children. Children (Basel) 2017; 4 (04) 28
    CrossrefPubMedSearch in Google Scholar
  • 16 Chisti MJ, Salam MA, Smith JH. , et al. Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh: an open, randomised controlled trial. Lancet 2015; 386 (9998): 1057-1065
    CrossrefPubMedSearch in Google Scholar
  • 17 Smith AG, Eckerle M, Mvalo T. , et al. CPAP IMPACT: a protocol for a randomised trial of bubble continuous positive airway pressure versus standard care for high-risk children with severe pneumonia using adaptive design methods. BMJ Open Respir Res 2017; 4 (01) e000195
    PubMedSearch in Google Scholar
  • 18 Hasegawa K, Tsugawa Y, Brown DFM, Mansbach JM, Camargo Jr CA. Trends in bronchiolitis hospitalizations in the United States, 2000-2009. Pediatrics 2013; 132 (01) 28-36
    CrossrefPubMedSearch in Google Scholar
  • 19 Pierce HC, Mansbach JM, Fisher ES. , et al. Variability of intensive care management for children with bronchiolitis. Hosp Pediatr 2015; 5 (04) 175-184
    CrossrefPubMedSearch in Google Scholar
  • 20 Dumas O, Mansbach JM, Jartti T. , et al. A clustering approach to identify severe bronchiolitis profiles in children. Thorax 2016; 71 (08) 712-718
    CrossrefPubMedSearch in Google Scholar
  • 21 Frizzola M, Miller TL, Rodriguez ME. , et al. High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol 2011; 46 (01) 67-74
    CrossrefPubMedSearch in Google Scholar
  • 22 Manley BJ, Owen LS, Doyle LW. , et al. High-flow nasal cannulae in very preterm infants after extubation. N Engl J Med 2013; 369 (15) 1425-1433
    CrossrefPubMedSearch in Google Scholar
  • 23 Mikalsen IB, Davis P, Øymar K. High flow nasal cannula in children: a literature review. Scand J Trauma Resusc Emerg Med 2016; 24: 93
    CrossrefPubMedSearch in Google Scholar
  • 24 Kepreotes E, Whitehead B, Attia J. , et al. High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial. Lancet 2017; 389 (10072): 930-939
    CrossrefPubMedSearch in Google Scholar
  • 25 Milési C, Essouri S, Pouyau R. , et al; Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP). High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study). Intensive Care Med 2017; 43 (02) 209-216
    CrossrefPubMedSearch in Google Scholar
  • 26 Vitaliti G, Vitaliti MC, Finocchiaro MC. , et al. Randomized comparison of helmet CPAP versus high-flow nasal cannula oxygen in pediatric respiratory distress. Respir Care 2017; 62 (08) 1036-1042
    CrossrefPubMedSearch in Google Scholar
  • 27 Franklin D, Dalziel S, Schlapbach LJ. , et al; PARIS and PREDICT. Early high flow nasal cannula therapy in bronchiolitis, a prospective randomised control trial (protocol): A Paediatric Acute Respiratory Intervention Study (PARIS). BMC Pediatr 2015; 15: 183
    CrossrefPubMedSearch in Google Scholar
  • 28 Scheltema NM, Gentile A, Lucion F. , et al; PERCH Study Group. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. Lancet Glob Health 2017; 5 (10) e984-e991
    CrossrefPubMedSearch in Google Scholar