ArticleIntensive care medicine2011
Optimal level of nasal continuous positive airway pressure in severe viral bronchiolitis.
Article in Intensive care medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- Continuous positive airway pressure (CPAP) for acute bronchiolitis in children.The Cochrane database of systematic reviews · 2022Pooled it
- Outcomes of High-Flow Nasal Cannula Vs. Nasal Continuous Positive Airway Pressure in Young Children With Respiratory Distress: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2021Pooled it
- Continuous positive airway pressure (CPAP) for acute bronchiolitis in children.The Cochrane database of systematic reviews · 2019Pooled it
- Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).Intensive care medicine · 2017Guideline
- Cost-effectiveness of high flow nasal cannula therapy versus continuous positive airway pressure for non-invasive respiratory support in paediatric critical care.Critical care (London, England) · 2024Trial
- A multicenter randomized controlled trial of a 3-L/kg/min versus 2-L/kg/min high-flow nasal cannula flow rate in young infants with severe viral bronchiolitis (TRAMONTANE 2).Intensive care medicine · 2018Trial
- 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 medicine · 2017Trial
- Transcutaneous Carbon Dioxide Monitoring During Weaning From Mechanical Ventilation in Children: The WeanCOPediatric pulmonology · 2025Article
- Total face mask with neurally adjusted ventilatory assist as a rescue therapy in infants with severe bronchiolitis.European journal of pediatrics · 2024Article
- Critical care of severe bronchiolitis during shortage of ICU resources.EClinicalMedicine · 2024Review
- Doing more with less: The use of non-invasive ventilatory support in a resource-limited setting.PloS one · 2023Article
- Safety and effectiveness of bubble continuous positive airway pressure as respiratory support for bronchiolitis in a pediatric ward.European journal of pediatrics · 2022Observational
- Innovations and adaptations in neonatal and pediatric respiratory care for resource constrained settings.Frontiers in pediatrics · 2022Review
- High-Flow Nasal Cannula versus Continuous Positive Airway Pressure in Critical Bronchiolitis: A Randomized Controlled Pilot.Journal of pediatric intensive care · 2020Article
- Neurally adjusted ventilatory assist decreases work of breathing during non-invasive ventilation in infants with severe bronchiolitis.Critical care (London, England) · 2019Article
- Derivation and Validation of an Objective Effort of Breathing Score in Critically Ill Children.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019Observational
- Use of bubble continuous positive airway pressure (bCPAP) in the management of critically ill children in a Malawian paediatric unit: an observational study.BMJ open respiratory research · 2019Observational
- Measurements Obtained From Esophageal Balloon Catheters Are Affected by the Esophageal Balloon Filling Volume in Children With ARDS.Respiratory care · 2018Article
- Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support.The Journal of pediatrics · 2017Article
- Comparison of CPAP and HFNC in Management of Bronchiolitis in Infants and Young Children.Children (Basel, Switzerland) · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo determine the optimal level of nasal continuous positive airway pressure (nCPAP) in infants with severe hypercapnic viral bronchiolitis as assessed by the maximal unloading of the respiratory muscles and improvement of breathing pattern and gas exchange.
methodsA prospective physiological study in a tertiary paediatric intensive care unit (PICU). Breathing pattern, gas exchange, intrinsic end expiratory pressure (PEEPi) and respiratory muscle effort were measured in ten infants with severe hypercapnic viral bronchiolitis during spontaneous breathing (SB) and three increasing levels of nCPAP.
resultsDuring SB, median PEEPi was 6 cmH(2)O (range 3.9-9.2 cmH(2)O), median respiratory rate was 78 breaths/min (range 41-96), median inspiratory time/total duty cycle (T (i)/T (tot)) was 0.45 (range 0.40-0.48) and transcutaneous carbon dioxide pressure (P (tc)CO(2)) was 61.5 mmHg (range 50-78). In all the infants, an nCPAP level of 7 cmH(2)O was associated with the greatest reduction in respiratory effort with a mean reduction in oesophageal and diaphragmatic pressure swings of 48 and 46%, respectively, and of the oesophageal and diaphragmatic pressure time product of 49 and 56%, respectively. During nCPAP, median respiratory rate decreased to 56 breaths/min (range 39-108, p < 0.05), median T (i)/T (tot) decreased to 0.40 (range 0.34-0.44, p < 0.50) and P (tc)CO(2) decreased to 49 mmHg (range 35-65, p < 0.05). Only one infant with associated bacterial pneumonia required intubation and all the infants were discharged alive from the PICU after a median stay of 5.5 (range 3-27 days).
conclusionIn infants with hypercapnic respiratory failure due to acute viral bronchiolitis, an nCPAP level of 7 cmH(2)O is associated with the greatest unloading of the respiratory muscles and improvement of breathing pattern, as well as a favourable short-term clinical outcome.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.