Rising Intensive Care Costs in Bronchiolitis Infants-Is Nasal High Flow the Culprit?

Abstract

Bronchiolitis remains the most common reason for nonelective hospital and intensive care admissions among young children (1). In an attempt to reduce the burden of the disease, many investigators have investigated pharmacological treatments or respiratory support methods to either reduce hospitalizations or costly intensive care. The current American, United Kingdom, and Australian bronchiolitis guidelines recommend supportive care only, a sobering outcome after decades of studies attempting to reduce the burden of disease (2–4). Well-conducted studies using noninvasive ventilation or nasal high flow (NHF) in bronchiolitis have demonstrated improved work of breathing, reduced requirement to escalate care, and reduced intubation rates but have not shown any reduction in hospital length of stay (5–8). Where and by whom supportive respiratory care is provided depends on hospital internal guidelines and local practice.