In recent years, ventilatory support in severe bronchiolitis has changed, with increased use of non-invasive ventilation (NIV) and the implementation of high-flow nasal cannula oxygen therapy (HFNC).
Analyse the impact of HFNC on patients with bronchiolitis: admission to PICU, length of stay (LOS) in the PICU, LOS in the hospital, describing changes observed between the periods 2010-2011 and 2016-2018.
Retrospective, observational, descriptive and comparative study of patients younger than one year that were admitted to the PICU with bronchiolitis. Demographic and clinical data collected include the ventilatory support received: HFNC, NIV or conventional mechanical ventilation (CMV), and the use of HFNC after CMV or NIV. LOS in both the PICU and the hospital was recorded. Statistical significance was set at p <0.05.
248 patients were included; 53 from 2010/2011 and 195 from 2016/2018. No differences were found between clinical variables at admission, nor in the LOS in PICU. The use of HFNC before PICU admission was significantly greater in 2016/2018. There was a 3% reduction in PICU admissions between the two periods, and the need for CMV decreased around 20% in the second period. Hospital’s LOS was significantly shorter for patients who received pre-admission HFNC 17.8 versus 11 days (p= 0.0005). HFNC for weaning did not reduce the PICU’s LOS 7 versus 7.5 days (p= 0.7).
The use of HFNC does not significantly reduce PICU admission, nor LOS in the PICU. However, a significant reduction in hospital LOS is observed for patients receiving pre-admission HFNC.