PT  - JOURNAL ARTICLE
AU  - Jilei Lin
AU  - Yin Zhang
AU  - Limei Xiong
AU  - Sha Liu
AU  - Caihui Gong
AU  - Jihong Dai
TI  - High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis
AID  - 10.1136/archdischild-2018-315846
DP  - 2019 Jun 01
TA  - Archives of Disease in Childhood
PG  - 564--576
VI  - 104
IP  - 6
4099  - http://adc.bmj.com/content/104/6/564.short
4100  - http://adc.bmj.com/content/104/6/564.full
SO  - Arch Dis Child2019 Jun 01; 104
AB  - Objectives To review the effects and safety of high-flow nasal cannula (HFNC) for bronchiolitis.Methods Six electronic databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, CQ VIP Database and Wanfang Data were searched from their inception to 1 June 2018. Randomised controlled trials (RCTs) which investigated the effects of HFNC versus other forms of oxygen therapies for bronchiolitis were included.Results Nine RCTs with 2121 children met the eligibility criteria. There was no significant difference in length of stay in hospital (LOS), length of oxygen supplementation (LOO), transfer to intensive care unit, incidence of intubation, respiratory rate, SpO2 and adverse events in HFNC group compared with standard oxygen therapy (SOT) and nasal continuous positive airway pressure (nCPAP) groups. A significant reduction of the incidence of treatment failure (risk ratio (RR) 0.50, 95% CI 0.40 to 0.62, p<0.01) was observed in HFNC group compared with SOT group, but there was a significant increase of the incidence of treatment failure (RR 1.61, 95% CI 1.06 to 2.42, p0.02) in HFNC group compared with nCPAP group. In subgroup analysis, LOS was significantly decreased in HFNC group compared with SOT group in low-income and middle-income countries.Conclusion The systematic review suggests HFNC is safe as an initial respiratory management, but the evidence is still lacking to show benefits for children with bronchiolitis compared with SOT or nCPAP.