New PREDICT research has shown that high flow oxygen therapy via nasal cannula can be safely delivered in emergency departments and general paediatrics wards in both large tertiary children’s hospitals and smaller regional centres. The outcome of the study showed that high flow therapy compared to standard oxygen therapy reduced the need for higher level of care from 23% to 12%.
The study, “A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis“, published in the prestigious New England Journal of Medicine, involved 17 hospitals across Australia and New Zealand, including researchers from PREDICT sites: Lady Cilento Children’s Hospital & the Paediatric Critical Care Research Group (PCCRG), Brisbane; Murdoch Children’s Research Institute & the Royal Children’s Hospital, Melbourne; Monash Medical Centre, Clayton; Gold Coast University Hospital; Townsville Hospital; The Canberra Hospital, ACT; Starship Children’s Hospital and KidzFirst Middlemore, Auckland, New Zealand. This collaboration makes it the largest paediatric study in this field worldwide.
Bronchiolitis is a common viral lung disease in infants with symptoms including cough, runny nose, difficulty breathing and poor feeding. Prior studies using different medications and other interventions have not seen any significant change in outcome or burden on the health care system.
Nasal high-flow therapy is a simple and easy to use oxygen therapy that works by delivering a higher volume of air and oxygen into the nasal passage than standard oxygen delivery methods. This results in an improvement in the work of breathing of infants with bronchiolitis.
The study involved 1472 patients under 12 months old with bronchiolitis. Infants were randomised 50/50 to one treatment arm and followed throughout their admission. The study compared two oxygen therapies: standard oxygen therapy via nasal cannula and high flow therapy via nasal cannula where a higher volume of air and oxygen is delivered into the nasal passages and results in more efficient delivery of oxygen to the airways and reduces the work of breathing.
The finding from this study could change standard practice in hospitals caring for infants with bronchiolitis worldwide.
The study was funded by the National Medical Health Research Council (NHMRC), the Emergency Medical Foundation, the Mater Foundation and local hospital Foundations.