Evidence map›Paper›PMID 39451018›Full record

ArticlePediatric pulmonology2025

High-flow nasal cannulas versus standard oxygen therapy for moderate bronchiolitis: a quasi-experimental analysis.

Livia Antilici, Anna C Vittucci, Sebastian Cristaldi, Anna M C Musolino, Mara Pisani, Lelia Rotondi Aufiero, Chiara V Di Maio, Rossana Scutari, Renato Cutrera, Andrea Dotta and 2 more

Abstract readComparative Study
In one paragraph

Article in Pediatric pulmonology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Livia AntiliciBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.ORCID http://orcid.org/0000-0003-0789-9779
Anna C VittucciBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.ORCID https://orcid.org/0000-0002-1164-5563
Sebastian CristaldiBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.
Anna M C MusolinoBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.
Mara PisaniBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.
Lelia Rotondi AufieroBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.
Chiara V Di MaioMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Rossana ScutariMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Renato CutreraPediatric Pulmonology and Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy.ORCID http://orcid.org/0000-0001-7711-5672
Andrea DottaMedical and Surgical Department of Fetus-Newborn-Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
Carlo F PernoMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Alberto VillaniBambino Gesù Children's Hospital IRCCS, Hospital University Pediatrics Clinical Area, Rome, Italy.

Funding

Italian Ministry of Health with Current Research funds
6 · The paper itself

Abstract

backgroundIn the last decades none of the medical therapies investigated have shown clear efficacy in the treatment of bronchiolitis, and literature agrees on a general de-implementation of pharmacological therapies, recognizing an effective role only to nutritional support and oxygen therapy. High-flow nasal cannulas (HFNC) has become increasingly popular in the last decade, despite its lack of clear efficacy. Recent randomized controlled trials (RCT) comparing standard oxygen therapy (SOT) and HFNC did not demonstrate significant benefit of HFNC. To acquire more clinical data on HFNC efficacy we performed a retrospective, quasi-experimental analysis of patients admitted for bronchiolitis in the epidemic seasons 2021-2022 and 2022-2023.

methodsTo assess the efficacy of SOT and HFNC we used a pragmatic approach, a fuzzy regression discontinuity design, which is a quasi-experimental test. Unlike RCTs, this process is not a true randomization, but may be interpreted as quasi-randomization in an observational setting.

resultsHFNC did not reduce length of oxygen therapy (LOO) nor length of hospitalization (LOS) (respectively, p: 0.383 and p: 0.454). Treatment failure was not significantly different in the treatment groups (p: 0.354).

conclusionsIt is crucial to perform additional RCTs with uniform protocols to determine the efficacy of HFNC more accurately in the treatment of bronchiolitis. HFNC does not reduce LOO, suggesting that early use of HFNC does not change the course of disease in moderate bronchiolitis. In view of the greater complexity and higher cost, HFNC should not be routinely used as first-line treatment in children with moderate respiratory distress and mild hypoxemia.

Indexed as

BronchiolitisCannulaOxygen Inhalation TherapyFemaleHumansInfantLength of StayMaleRetrospective StudiesTreatment Outcomebronchiolitishigh‐flow nasal cannulasRSVstandard oxygen therapy

Identifiers

PMID39451018
PMCPMC11740650

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.