In a large cohort of infants at children’s hospitals, noninvasive and invasive ventilation increased significantly from 2010 to 2018. Hospital-level noninvasive ventilation utilization was not associated with a reduction in invasive ventilation but was associated with higher rates of cardiac arrest even after controlling for severity.

Noninvasive ventilation in bronchiolitis may incur an unintended higher risk of cardiac arrest, and this requires further investigation.

Primary outcomes were rates of noninvasive ventilation, invasive ventilation, and cardiac arrest.

Trends over time were assessed with univariate logistic regression.

In the main analysis, hospital-level multivariable logistic regression evaluated rates of outcomes including invasive ventilation and cardiac arrest among hospitals with high and low utilization of noninvasive ventilation.

The study included 147,288 hospitalizations of infants with bronchiolitis.

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