Bronchiolitis is the most common reason for hospitalization in infants worldwide. Current recommendations by the American Academy of Pediatrics are for supportive care including maintenance of hydration and oxygen support for hypoxemia. Other interventions such as the use of bronchodilators have failed to show any benefit when compared to supportive care alone. However, it has been proposed that the obstructive process of bronchiolitis that causes increased work of breathing, hypoxia, and hypercapnea might respond to the moderate positive pressure provided by high-flow oxygen therapy.

The randomized control trial referenced here was conducted in Australia and New Zealand across multiple institutions on otherwise healthy infants (less than 12 months old) with bronchiolitis with an oxygen requirement.

The trial showed a 11% absolute risk reduction in the need for escalation of care in patients receiving high-flow oxygen therapy.

High-flow oxygen therapy in infants with bronchiolitis reduces the risk of treatment failure and the need for escalation of care. However, it does not offer any benefit as far as direct patient-centered outcomes are concerned.

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