Bronchiolitis is the number one cause of nonelective admission worldwide. Emergency medicine professionals everywhere, regardless of any specialized pediatric emergency medicine training, treat children with bronchiolitis. We see this disease process so frequently that it has its own season in most geographic locations, and staffing for departments is adjusted according to it. I felt that this study, published in the New England Journal of Medicine , is one we would all benefit from knowing about and discussing.[1]
Study Summary
This was a multicenter, randomized trial comparing a "standard" therapy group of patients receiving supplemental oxygen via nasal cannula and a "high-flow" therapy group of patients receiving supplemental oxygen via a high-flow nasal cannula (HFNC) through an Optiflow™ system (Fisher & Paykel Healthcare; Auckland, New Zealand). A final study population of 1472 patients enrolled between 2013 and 2016 were randomized into the two groups.
The study took place in emergency departments and inpatient pediatric wards at 17 hospitals in Australia and New Zealand. Clinicians were not blinded to the treatment groups owing to the obvious visual difference between the two therapies, but they were blinded to the outcome data until all data were fully collected.
The primary outcome for this study was treatment failure requiring escalation of care on the basis of meeting at least three of four prespecified criteria.
