SynthesisBMJ open respiratory research2021
Efficacy and safety of high flow nasal oxygen for children with bronchiolitis: systematic review and meta-analysis.
Synthesis in BMJ open respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 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
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- High-Flow Oxygen Therapy vs. Continuous Positive Airway Pressure in Hospitalised Bronchiolitis: A Meta-Analysis.Acta paediatrica (Oslo, Norway : 1992) · 2026Pooled it
- Application of the TIDieR checklist to improve the HFNC use in bronchiolitis management.European journal of pediatrics · 2024Pooled it
- High-flow nasal cannula therapy for infants with bronchiolitis.The Cochrane database of systematic reviews · 2024Pooled it
- Systematic review and meta-analysis of efficacy and safety of continuous positive airways pressure versus high flow oxygen cannula in acute bronchiolitis.BMC pediatrics · 2022Pooled it
- The Application Effect of Modified Pressure-Reducing Fixation Protective Nasal Strip in the Nursing Care of Patients Receiving High-Flow Nasal Cannula Therapy.Saudi medical journal · 2026Trial
- Impact of a nurse-driven high-flow nasal cannula weaning protocol on HFNC duration in infants with bronchiolitis: a randomized controlled trial.European journal of pediatrics · 2026Trial
- "Comparison between high-flow nasal cannula (HFNC) therapy and noninvasive ventilation (NIV) in children with acute respiratory failure by bronchiolitis: a randomized controlled trial".BMC pediatrics · 2024Trial
- Trial
- Review
- Article
- Application of the 2023 Italian guidelines for respiratory support management in acute viral bronchiolitis: a retrospective study.BMJ paediatrics open · 2025Observational
- Characteristics and outcomes of children initiated on high flow nasal cannula and continuous positive airway pressure at the emergency centre of a district hospital in South Africa.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Predictive factors for high-flow nasal cannula failure in patients with acute viral bronchiolitis admitted to the pediatric intensive care unit.Critical care science · 2025Article
- High-flow weaning strategies for infants with bronchiolitis: protocol for a pilot randomised controlled trial in the UK.BMJ open · 2024Article
- High-flow nasal cannula is an expensive and clunky placebo: myth or maxim?Breathe (Sheffield, England) · 2024Review
- Respiratory Syncytial Virus: The Urgent Need for Innovative Preventive Strategies.Pediatric reports · 2024Article
- High-flow nasal cannula use in pediatric patients for other indications than acute bronchiolitis-a scoping review of randomized controlled trials.European journal of pediatrics · 2024Article
- Nasal CPAP in the Pediatric Ward to Reduce PICU Admissions for Severe Bronchiolitis?Pediatric reports · 2023Article
- Advances in Management of Respiratory Failure in Children.Indian journal of pediatrics · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo assess the published evidence to establish the efficacy and safety of high flow oxygen cannula (HFNC) as respiratory support for children up to 24 months of age with bronchiolitis within acute hospital settings.
methodsWe searched eight databases up to March 2021. Studies including children up to 24 months of age with a diagnosis of bronchiolitis recruited to an randomised controlled trial were considered in the full meta-analysis. At least one arm of the study must include HFNC as respiratory support and report at least one of the outcomes of interest. Studies were identified and extracted by two reviewers. Data were analysed using Review Manager V.5.4.
resultsFrom 2943 article titles, 308 full articles were screened for inclusion. 23 studies met the inclusion criteria, 15 were included in the metanalyses. Four studies reported on treatment failure rates when comparing HFNC to standard oxygen therapy (SOT). Data suggests HFNC is superior to SOT (OR 0.45, 95% CI 0.36 to 0.57). Four studies reported on treatment failure rates when comparing HFNC to continuous positive airways pressure (CPAP). No significant difference was found between CPAP and HFNC (OR 1.64, 95% CI 0.96 to 2.79; p=0.07). Four studies report on adverse outcomes when comparing HFNC to SOT. No significant difference was found between HFNC & SOT (OR 1.47, 95% CI 0.54 to 3.99).
conclusionHFNC is superior to SOT in terms of treatment failure and there is no significant difference between HFNC and CPAP in terms of treatment failure. The results suggest HFNC is safe to use in acute hospital settings.
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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.