Importantly bronchiolitis is the most common cause for admission to hospital and Intensive Care Unit in the first 2 years of life in the Hunter and in developed countries. Treatment is supportive with oxygen given as needed, but unfortunately, the optimal mode of oxygen supplementation is unknown. This lack of evidence for choosing the most effective mode of delivery for oxygen therapy results in an enormous disease burden among babies worldwide, including prolonged hospital admission and related costs as well as the need for potentially unnecessary escalation of therapy (e.g. mechanical ventilation) and its related complications (e.g. death). Recently, high-flow nasal prong warm humidified oxygen has shown promise in observational studies involving infants with bronchiolitis, but this has not been systematically studied.
We have therefore started to conduct a randomised controlled trial (RCT) comparing high-flow nasal prong warm humidified oxygen (HFNP WHO) versus standard nasal prong cold humidified oxygen (Standard Therapy) in the treatment of oxygen-dependent moderate bronchiolitis in infants aged < 24 months at the Newcastle Children's Hospital. We hypothesise that treatment with HFNP WHO will reduce time on oxygen (and therefore hospitalisation time) and treatment failures (requiring escalation of therapy, usually to ICU). This RCT will identify the optimal mode of oxygen delivery to infants admitted to hospital with bronchiolitis and has the potential to provide evidence for a novel treatment approach that significantly reduces disease burden in early life and health care costs.