High Flow Nasal Cannula and Non Invasive Ventilation for Acute Bronchiolitis in the Paediatric Wards.

IF 2.4 4区 医学 Q1 PEDIATRICS
Acta Paediatrica Pub Date : 2025-07-02 DOI:10.1111/apa.70212
Luca Pierantoni, Giacomo Stera, Carlotta Biagi, Arianna Dondi, Lawrence M Scheier, Marcello Lanari
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引用次数: 0

Abstract

Aim: Bronchiolitis is a leading cause of respiratory distress and hospital admissions in infants. While high-flow nasal cannula is effective for patients unresponsive to standard oxygen therapy, evidence regarding continuous positive airway pressure and noninvasive ventilation in the wards remains inconclusive. This review explores the feasibility and criteria for initiation, titration, and monitoring of high-flow nasal cannula, continuous positive airway pressure, and noninvasive ventilation in infants with bronchiolitis in paediatric wards.

Methods: Narrative review of studies from PubMed and the Cochrane Library (2000-2024), focusing on high-flow nasal cannula, continuous positive airway pressure, and noninvasive ventilation in bronchiolitis, particularly in paediatric wards.

Results: High-flow nasal cannula is widely used in paediatric wards as a safe and effective option for bronchiolitis. Evidence for continuous positive airway pressure and noninvasive ventilation outside intensive care is limited but suggests potential to reduce escalation in selected cases.

Conclusion: Continuous positive airway pressure and noninvasive ventilation in paediatric wards appear to carry limited safety concerns. While not proven superior to high-flow nasal cannula or standardised in their use, when applied selectively with trained staff and close monitoring, they may serve as rescue therapies. Better understanding of current evidence may support standardisation and improve resource allocation.

儿科病房急性细支气管炎的高流量鼻插管和无创通气。
目的:毛细支气管炎是婴儿呼吸窘迫和住院的主要原因。虽然高流量鼻插管对标准氧疗无反应的患者有效,但关于病房持续气道正压通气和无创通气的证据仍不确定。本综述探讨了在儿科病房对毛细支气管炎患儿实施高流量鼻插管、持续气道正压通气和无创通气的可行性和标准。方法:叙叙性回顾PubMed和Cochrane图书馆(2000-2024)的研究,重点关注细支气管炎,特别是儿科病房的高流量鼻插管,持续气道正压通气和无创通气。结果:高流量鼻插管作为一种安全有效的治疗细支气管炎的方法被广泛应用于儿科病房。在重症监护室外持续气道正压通气和无创通气的证据有限,但表明在某些病例中有可能减少病情升级。结论:儿科病房持续气道正压通气和无创通气的安全性问题有限。虽然没有被证明优于高流量鼻插管或其使用标准化,但当有选择地在训练有素的工作人员和密切监测下应用时,它们可以作为抢救疗法。更好地了解现有证据可能有助于标准化和改善资源分配。
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来源期刊
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
期刊介绍: Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries
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