Study aim
Looking at whether high-flow nasal cannula (HFNC) is more effective than humidified oxygen (moderate cases) or CPAP (severe cases) in children with bronchiolitis
Inclusion Criteria
- Hospitalised infant aged <12 months with a clinical diagnosis of acute bronchiolitis
AND - Clinically assessed at least twice, 15 minutes apart to have lack of response to LFNC oxygen up to 2 L/min, as indicated by persistent hypoxaemia (SpO2 <90%, or <92% if age < 6 weeks or if underlying health problems present) and/or moderate respiratory distress (respiratory rate 55-70/min and moderate chest recession) [MODERATE BRONCHIOLITIS stratum].
Exclusion Criteria
- Clinical decision that patient needs immediate intubation and ventilation for life-threatening hypoxaemia, shock or decreased conscious level.
- Prolonged apnoeas (>10 seconds needing stimulation).
- Ongoing active air leak (pneumothorax, pneumomediastinum).
- Received HSO, HFNC or CPAP for over 2 hours in the previous 24 hours.
- On home ventilation prior to hospital admission.
- Tracheostomy in place.
- Choanal atresia/stenosis, midfacial anomalies or recent craniofacial surgery.
- Previously recruited to the BACHb trial in the last 90 days
Enrollment conflicts
- None: Co-enrolment with observational studies is permitted without prior agreement
Step-by-step recruitment guide
Standard working hours (09:00 – 17:00)
1
Contact the ED Research Team when an eligible patient arrives in the ED — send a message via Epic chat to "ED Research Team" or phone 217907.
2
The ED Research Team will see the patient to arrange consent and randomisation.
Out of hours & weekends
X
There is no out-of-hours recruitment for this study