High Flow Nasal Cannula treatment for viral Bronchiolitis, a randomised controlled trial

A new way for oxygen treatment in infants with viral respiratory infections.

Grant ID: EMPJ-111R21-2014

Project Summary

Acute respiratory disease is the leading cause for infants and children needing hospital admission. The main focus of hospital treatment is oxygen therapy beside disease specific treatment like inhalers for asthma or antibiotics for pneumonia. 10 to 20% of these infants or children need higher level of care at some point of their illness and will be transferred to a children’s hospital intensive care unit. This is not only expensive and imposes a huge burden on health care costs but more importantly is very stressful for these children and families because they are taken out of their familiar environment. Recent research suggests that with early optimal respiratory support the need for transfer can be significantly reduced and many of these patients could be cared in their regional hospital allowing the family to be the main support group. This concept of “keeping the patients in their regional centre” is not only from a psychosocial aspect of advantage but will have as well a great impact on health care costs. Our research group has recently investigated the role of high flow therapy in infants with bronchiolitis and we were able to demonstrate a 40% reduction in intensive care admission. Early respiratory intervention is a fundamentally new approach, which has the potential to prevent progression and deterioration of respiratory illness. The aim of this study is to investigate the role of high flow therapy in infants with bronchiolitis, but future research and trials will also include other conditions such as asthma and pneumonia.

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Outcomes

See Pilot 1 page: https://emergencyfoundation.org.au/projects/high-flow-nasal-cannula-therapy-in-infants-with-bronchiolitis/

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Leveraged Funds

- $1,200,000.00 NHMRC

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Dissemination

Franklin, D., Shellshear, D., Babl, F.E., Schlapbach, L.J., Oakley, E., Borland, M.L., Hoeppner, T., George, S., Craig, S., Neutze, J. and Williams, A., 2019. Multicentre, randomised trial to investigate early nasal high—flow therapy in paediatric acute hypoxaemic respiratory failure: a protocol for a randomised controlled trial—a Paediatric Acute respiratory Intervention Study (PARIS 2). BMJ open, 9(12), p.e030516.

Oakley, E., Brys, T., Borland, M., Neutze, J., Phillips, N., Krieser, D., Dalziel, S.R., Davidson, A., Donath, S., Jachno, K. and South, M., 2018. Medication use in infants admitted with bronchiolitis. Emergency Medicine Australasia, 30(3), pp.389-397.

Franklin, D. and Schibler, A., 2018. Nasal high-flow therapy in infants and children. Pediatric Respirology and Critical Care Medicine, 2(1), p.2.

Schlapbach, L.J., Straney, L., Gelbart, B., Alexander, J., Franklin, D., Beca, J., Whitty, J.A., Ganu, S., Wilkins, B., Slater, A. and Croston, E., 2017. Burden of disease and change in practice in critically ill infants with bronchiolitis. European Respiratory Journal, 49(6).

Maul, C.P., Franklin, D., Williams, T., Schlapbach, L. and Schibler, A., 2017. Nasal High‐Flow Therapy in Children: A Survey of Current Practice in Australia. Journal of paediatrics and child health, 53(10), pp.1031-1032.

Schibler, A. and Franklin, D., 2016. Respiratory support for children in the emergency department. Journal of paediatrics and child health, 52(2), pp.192-196.

Pham, T.M., O'Malley, L., Mayfield, S., Martin, S. and Schibler, A., 2015. The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis. Pediatric pulmonology, 50(7), pp.713-720.

Mayfield, S., Bogossian, F., O'Malley, L. and Schibler, A., 2014. High‐flow nasal cannula oxygen therapy for infants with bronchiolitis: Pilot study. Journal of paediatrics and child health, 50(5), pp.373-378.

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