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Humidified high-flow nasal cannula oxygen for bronchiolitis: should we go with the flow?
  1. Ariel O Mace1,
  2. James Gibbons1,
  3. André Schultz2,3,4,
  4. Geoff Knight5,
  5. Andrew C Martin1,4
  1. 1Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia
  2. 2Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia
  3. 3Telethon Kids Institute, University of Western Australia, Perth, Australia
  4. 4School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
  5. 5Paediatric Intensive Care Unit, Princess Margaret Hospital for Children, Perth, Australia
  1. Correspondence to Dr Ariel O Mace, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia; ariel.mace{at}health.wa.gov.au

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Despite living in an era of evidence-based medicine and austerity, where every health dollar must be justified, the use of humidified high-flow nasal cannula oxygen (HFNC) in children with bronchiolitis has become increasingly prevalent,1 with limited evidence to substantiate its clinical benefit or economic worth. Current National Institute for Health and Care Excellence (NICE 2015) guidelines for bronchiolitis state that ‘the use of this medical device is becoming widespread without demonstration of additional efficacy’. Recent studies by Kepreotes et al2 and Riese et al3 have shown that the use of ward-based HFNC in children with bronchiolitis did not reduce the hospital length of stay (LOS) or rate of admission to the paediatric intensive care unit (PICU), when compared with standard low-flow oxygen therapy. …

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