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| Associate Professor Simon Craig |
The study, which compared traditional ‘low-flow’ oxygen to high-flow
therapy in 1472 infants, found that the need to escalate care was less in those
receiving high-flow.
Published last week in the New England Journal of Medicine, the
study involved 17 hospitals across Australia and New Zealand, including
researchers from Monash University, Monash Children’s Hospital, the Paediatric
Critical Care Research Group (PCCRG) located at the Lady Cilento Children’s
Hospital and the Paediatric Research in Emergency Departments International
Collaborative (PREDICT). This collaboration makes it the largest paediatric
study in this field worldwide.
Bronchiolitis—caused by a viral infection in the lungs—is the
most common reason for infants under 12 months to be admitted to hospital, with
10 per cent of them requiring intensive care.
Study co-author Associate Professor Simon Craig from Monash
University said the team found that high-flow oxygen therapy – a treatment which
originated from intensive care units - was safe in the ward environment and led
to less escalation of care. However, the study showed no difference in hospital
length of stay, need for intensive care admission, or duration of oxygen
therapy between the two treatment groups.
“We have demonstrated that stepping up to high-flow is safe in
the ward environment,” said Associate Professor Craig, who is also a Monash
Health paediatric emergency physician.
“Some children with bronchiolitis get sicker while in hospital. We’ve
found that a therapy which was previously reserved for intensive care units can
be delivered safely in emergency departments and on general paediatric wards,” Associate
Professor Craig said.
“This means that we can reduce the number of infants and their
families from regional areas who need to be relocated to one of the major
cities for the duration of their illness.
“Relocating a family means they are unfamiliar with their
surrounds and don’t have access to their usual support network.
“Most children with bronchiolitis don’t need high-flow therapy.
However, it’s nice to know that – if they need it – we can do it safely outside
of intensive care. This lets us keep children in their own community hospitals,
reducing the impact on the child and the family,” Associate Professor Craig
said.
High-flow nasal oxygen therapy works by delivering a higher
volume of air and oxygen into the nasal passages to improve breathing.
The research was led by The University of Queensland Mater
Research Institute (UQ-MRI) and Lady Cilento Children’s Hospital and funded by
the National Health and Medical Research Council, the Emergency Medicine
Foundation, the Mater Foundation and several Australian hospital foundations.
