High Flow Nasal Cannula RCT

Bronchiolitis, a viral lung disease in infants, is the most common reason worldwide for infants <1 year of age to be admitted into hospital, with approximately 9000 admissions occurring annually in Australia alone.    Over the last decade a new method to provide respiratory support to infants <1 year of age with bronchiolitis has emerged, high flow nasal cannula (HFNC). Non-experimental evidence, from our group, has shown that HFNC in bronchiolitis can be applied very early in the disease process, can be provided on paediatric wards (both regional and tertiary centres), reduces the need for PICU admission, and reduces the need for non-invasive and invasive ventilation once in PICU. However, the majority of this evidence has focused on critically ill infants with bronchiolitis, the role of HFNC in moderately unwell hospitalised infants with bronchiolitis, the majority of infants hospitalised with bronchiolitis, has yet to be defined. We will perform a large multi-centre randomised trial comparing respiratory support and oxygen delivery via HFNC with respiratory support and oxygen delivery via standard nasal cannula in infants admitted to hospitals with bronchiolitis, in Australia and New Zealand, to determine which treatment strategy results in less clinical deterioration. In addition, we will assess the health care cost of the two treatment strategies.

Study design

Open label, multi-centre, randomised controlled trial

Chief Investigator

Andreas Schibler

Time frame

2015 – 2018


  • National Health and Medical Research Council (project)
  • Emergency Medicine Foundation
  • Townsville Hospital Foundation
  • Murdoch Children’s Research Institute
  • Ipswich Hospital Foundation
  • Gold Coast Hospital Foundation

Site locations

  • Ipswich Hospital, Queensland, Australia
  • Caboolture Hospital, Queensland, Australia
  • Redland Hospital, Queensland, Australia
  • Redcliffe Hospital, Queensland, Australia
  • The Prince Charles Hospital, Queensland, Australia
  • Gold Coast University Hospital, Brisbane, Australia
  • Toowoomba Hospital, Queensland, Australia
  • Logan Hospital, Queensland, Australia
  • Nambour Hospital, Queensland, Australia
  • Lady Cilento Children’s Hospital, South Brisbane, Queensland, Australia
  • Townsville Hospital, Queensland, Australia.
  • The Tweed Hospital, Tweed Heads, New South Wales, Australia
  • Royal Children’s Hospital, Melbourne, Australia
  • Monash Children’s Hospital, Victoria, Australia
  • The Canberra Hospital, ACT, Australia
  • Starship Children’s Hospital, Auckland, New Zealand
  • KidzFirst Middlemore Hospital, Auckland, New Zealand


1400 infants 0 – 12 months with bronchiolitis (700 per group)