Efficacy of High-Flow Nasal Cannula Therapy Compared with Conventional Oxygen Therapy in Children with Bronchiolitis

Background: Bronchiolitis is an acute respiratory condition in the pediatric population, which sometimes requires hospital admission and supplemental oxygen therapy. Conventional oxygen therapy has been in use; however, High-flow nasal cannula (HFNC) is now increasingly being used because of potential clinical advantages. The current study aimed to compare the clinical effectiveness of HFNC with conventional oxygen therapy in children with acute respiratory distress. Material and Methods: This prospective observational study was done in the Department of Pediatrics of a Tertiary care teaching hospital. A total of n=200 children diagnosed with bronchiolitis were included in the study. They were allotted into two equal groups: conventional oxygen (n=100) and HFNC group (n=100). Baseline demographics were recorded. Clinical variables compared were respiratory rate, heart rate, oxygen saturation, and work of breathing at admission and defined intervals. Appropriate statistical analysis was performed. Results: Baseline characteristics of the cohort were found to be comparable, indicating adequate distribution for comparison. The analysis of values at 2 hours of therapy showed the HFNC group demonstrated a significantly greater reduction in respiratory rate (55.04 ± 5.26 vs 65.48 ± 7.12 breaths/min) with significant p-values. This lasted at 4-hour intervals and 6-hour intervals. Heart rate reduction was also significantly greater in HFNC groups at 2 hours and 6 hours (156.0 ± 4.85 vs 168.12 ± 4.67 bpm) and (129.76 ± 8.90 vs 152.56 ± 13.86 bpm). Oxygen saturation in the HFNC group improved more rapidly with HFNC at 2 hours (97.14 ± 1.36% vs 94.92 ± 3.72%). Logistic regression analysis results found that HFNC therapy significantly reduced the odds of treatment failure (OR 0.457; 95% CI 0.176–0.984; p<0.01). Conclusion: Our study found that HFNC therapy cases showed superior clinical outcomes as compared to conventional oxygen therapy in pediatric cases with acute respiratory distress. Therefore, it may be preferred as one of the effective methods of a non-invasive respiratory support strategy in the pediatric population.

Keywords: Acute respiratory distress, Bronchiolitis, Conventional oxygen therapy, High-nasal cannula (HFNC) therapy.