ArticleBMC pediatrics2017
Non-invasive respiratory support for infants with bronchiolitis: a national survey of practice.
Article in BMC pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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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.
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Who cites it
12 citing papers in PubMed, 55 citations in OpenAlex.
- FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): a multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in paediatric critical care.Critical care (London, England) · 2018Trial
- Trial
- Infants with bronchiolitis with high-flow nasal cannula in the paediatric ward. Is there a role for the ROXi (respiratory rate-oxygenation index) in predicting failure of high-flow nasal cannula?European journal of pediatrics · 2025Observational
- Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security.The Lancet. Global health · 2025Review
- Nasal CPAP in the Pediatric Ward to Reduce PICU Admissions for Severe Bronchiolitis?Pediatric reports · 2023Article
- Outcome of Noninvasive Respiratory Support in Pediatric High-Dependency Units for Acute Respiratory Distress.Respiratory care · 2023Article
- Efficacy of prophylactic high-flow nasal cannula therapy for postoperative pulmonary complications after pediatric cardiac surgery: a prospective single-arm study.Journal of anesthesia · 2023Article
- Safety and effectiveness of bubble continuous positive airway pressure as respiratory support for bronchiolitis in a pediatric ward.European journal of pediatrics · 2022Observational
- RSV disease in infants and young children: Can we see a brighter future?Human vaccines & immunotherapeutics · 2022Article
- Closed-loop oxygen control improves oxygenation in pediatric patients under high-flow nasal oxygen-A randomized crossover study.Frontiers in medicine · 2022Article
- Predicting Failure of Non-Invasive Ventilation With RAM Cannula in Bronchiolitis.Journal of intensive care medicine · 2022Article
- A nationwide survey on the use of heated humidified high flow oxygen therapy on the paediatric wards in the UK: current practice and research priorities.BMC pediatrics · 2020Article
Corrections and comments
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Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBronchiolitis is a common respiratory illness of early childhood. For most children it is a mild self-limiting disease but a small number of children develop respiratory failure. Nasal continuous positive airway pressure (nCPAP) has traditionally been used to provide non-invasive respiratory support in these children, but there is little clinical trial evidence to support its use. More recently, high-flow nasal cannula therapy (HFNC) has emerged as a novel respiratory support modality. Our study aims to describe current national practice and clinician preferences relating to use of non-invasive respiratory support (nCPAP and HFNC) in the management of infants (<12 months old) with acute bronchiolitis.
methodsWe performed a cross-sectional web-based survey of hospitals with inpatient paediatric facilities in England and Wales. Responses were elicited from one senior doctor and one senior nurse at each hospital. We analysed the proportion of hospitals using HFNC and nCPAP; clinical thresholds for their initiation; and clinician preferences regarding first-line support modality and future research.
resultsThe survey was distributed to 117 of 171 eligible hospitals; 97 hospitals provided responses (response rate: 83%). The majority of hospitals were able to provide nCPAP (89/97, 91.7%) or HFNC (71/97, 73.2%); both were available at 65 hospitals (67%). nCPAP was more likely to be delivered in a ward setting in a general hospital, and in a high dependency setting in a tertiary centre. There were differences in the oxygenation and acidosis thresholds, and clinical triggers such as recurrent apnoeas or work of breathing that influenced clinical decisions, regarding when to start nCPAP or HFNC. More individual respondents with access to both modalities (74/106, 69.8%) would choose HFNC over nCPAP as their first-line treatment option in a deteriorating child with bronchiolitis.
conclusionsDespite lack of randomised trial evidence, nCPAP and HFNC are commonly used in British hospitals to support infants with acute bronchiolitis. HFNC appears to be currently the preferred first-line modality for non-invasive respiratory support due to perceived ease of use.
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