23 March 2018

A landmark Queensland-led study into the emergency care and management of infants with bronchiolitis is set to change the way the disease is treated in hospitals internationally.

The Paediatric Acute Respiratory Intervention Study (PARIS) by the Paediatric Critical Care Research Group (PCCRG) based in the Queensland Children’s Hospital and the Paediatric Research in Emergency Department International Collaborative (PREDICT) found that nasal high-flow therapy halved the number of children requiring escalation of care for bronchiolitis.

Bronchiolitis is a common chest infection in young children, caused by a viral infection of the lungs. The infection triggers inflammation and mucus to build up in the airways, causing a cough and making it more difficult to breathe and feed.

It is the most common reason worldwide for infants under 12 months of age to be admitted to hospital.

Queensland Children’s Hospital paediatric intensivist and PCCRG Medical Leader, Associate Professor Andreas Schibler said the findings would be a game changer.

“Nasal high-flow therapy works by delivering a higher volume of air and oxygen into the nasal passages than standard oxygen delivery methods. This results in more efficient delivery of oxygen to the airways and reduces the work of breathing for the infants affected,” Associate Professor Schibler said.

“The study found that nasal high-flow therapy reduced the need for escalation of care by half – from 23 per cent in standard oxygen delivery to 12 per cent for infants receiving nasal high-flow therapy.”

Associate Professor Schibler said the study has also proven that nasal high-flow therapy could be delivered safely outside of paediatric intensive care settings.

“This means that emergency departments and general paediatric wards at adult hospitals of all sizes, in both metropolitan and regional hospitals, can safely and quickly provide this therapy for children in their local communities.”

An article on the study, titled High-flow Therapy for Infants with Bronchiolitis – A Randomized Trial has been published in the latest edition of the prestigious New England Journal of Medicine.

The study was funded by the National Medical Health Research Council (NHMRC), the Emergency Medical Foundation, the Mater Foundation and local hospital Foundations.

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