TY - JOUR T1 - What is the optimal flow on starting high-flow oxygen therapy for bronchiolitis treatment in paediatric wards? JO - Anales de Pediatría (English Edition) T2 - AU - González Martínez,Felipe AU - González Sánchez,María Isabel AU - Pérez-Moreno,Jimena AU - Toledo del Castillo,Blanca AU - Rodríguez Fernández,Rosa SN - 23412879 M3 - 10.1016/j.anpede.2018.11.013 DO - 10.1016/j.anpede.2018.11.013 UR - https://analesdepediatria.org/en-what-is-optimal-flow-on-articulo-S2341287919301061 AB - IntroductionHigh-flow nasal cannula (HFNC) is a safe and effective treatment in bronchiolitis in paediatric wards. The optimal flow on starting HFNC is still unknown. The main aim of this study was to determine if there were differences in clinical outcome of patients according the initial flow. MethodsA prospective, observational and analytical study was conducted between 2014 and 2016 on infants admitted with bronchiolitis and who required HFNC. Two cohorts were established according to the initial flow: cohort 1: flow 15L/min (HFNC-15), and cohort 2: flow 10L/min (HFNC-10). Treatment failure was defined as the presentation of apnoea or the absence of clinical improvement in the first 12–24h. Multivariate probabilistic models were built to identify predictive variables of treatment failure. ResultsA total of 57 patients were included. The median age was 4 months (IQR 2–13), and 54% received treatment with HFNC-10 and 46% with HFNC-15. In HFNC-15 cohort, respiratory rate (RR) decreased in the first hour, and in the HFNC-10 cohort in the first 6h (P=.03). In HFNC-10 cohort, treatment failure rate was 71%, compared to 15% of HFNC-15 (P<.01). Admission to PICU was required in 35% of the HFNC-10 group vs 18% in HFNC-15 (P=.11). No adverse effects were found. ConclusionsThe use of HFNC 15L/min in bronchiolitis treatment in paediatric wards is safe and effective, achieves a faster improvement of respiratory rate and has a lower treatment failure rate. ER -