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In their article, Thia et al attempted to address the potential benefit of nasal continuous positive airway pressure (NCPAP) compared with the currently practiced standard treatment in the management of infants with bronchiolitis.1 After the established use of NCPAP in neonates, it is promising to see its value being assessed for the use in infants for one of the commonest causes of respiratory compromise. By restricting their outcome measures to demonstrable and achievable partial pressure of capillary carbon dioxide (pCO2) changes the authors have done justice to the aim of the study.
However, a number of clinical and methodological concerns need to be further reflected upon before the authors’ conclusions are applied to standard practice.
The duration of the illness prior to the commencement of treatment in the two groups is not mentioned (even though a comparison was made to the non-included group).
“Comparison of NCPAP with standard treatment”, as stated in their aim, is not happening using their applied methodology. Instead they are comparing the staged introduction of NCPAP with standard treatment …