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The most recent version of this article was published on 1 January 2008

Arch Dis Child. Published Online First: 7 March 2007. doi:10.1136/adc.2005.091231
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health
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Original articles

Randomised controlled trial of nasal Continuous Positive Airways Pressure (CPAP) in bronchiolitis

Lena P Thia 1*, Sheila A McKenzie 1, Tom P Blyth 1, Caro C Minasian 1, Wanda J Kozlowska 1 and Siobhan B Carr 2

1 Dept of Paediatric Respiratory Medicine, Royal London Hospital, United Kingdom
2 Dept of Paediatirc Respiratory Medicine, Royal London Hospital, United Kingdom

* To whom correspondence should be addressed. E-mail: lthia{at}doctors.org.uk.

Accepted 19 February 2007


*   Abstract

Aims: To compare CPAP with standard treatment (ST) in the management of bronchiolitis.

Methods: Children <1 year with bronchiolitis and capillary pCO2 > 6kPa were recruited and randomised to CPAP or ST and then crossed over to the alternative treatment after 12 hours. ST was intravenous fluids and supplemental oxygen by nasal prongs or facemask. The change in pCO2 was compared between the groups after 12 and 24 hours. Secondary outcomes were change in capillary pH, respiratory rate, pulse rate and the need for invasive ventilatory support.

Results: 29 of 31 children completed the study. pCO2 after 12 hours fell by 0.92kPa in children treated with CPAP compared to a rise of 0.04kPa in those on ST (p< 0.015). If CPAP was used first, there was a significantly better reduction in pCO2 than if it was used second. There were no differences in secondary outcome measures. CPAP was well tolerated with no complications identified.

Conclusions: This study suggests that CPAP compared to ST improves ventilation in children with bronchiolitis and hypercapnoea.

Keywords: bronchiolitis, continuous positive airways pressure (CPAP)




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Crossover design is not appropriate for CPAP RCT
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