Nasal Continuous Positive Airway Pressure in Bronchiolitis: A Randomized Controlled Trial

ABSTRACT

Objective: To evaluate the efficacy of nasal continuous positiveairway pressure (nCPAP) in decreasing respiratory distress inbronchiolitis.Design: Randomized controlled trial.Setting: Tertiary-care hospital in New Delhi, India.Participants: 72 infants (age <1y) hospitalized with a clinicaldiagnosis of bronchiolitis were randomized to receive standardcare, or nCPAP in addition to standard care, in the first hour afteradmission. 23 parents refused to give consent for participation. 2infants did not tolerate nCPAP.Intervention The outcome was assessed after 60 minutes. IfnCPAP was not tolerated or the distress increased, the infant wasswitched to standard care. Analysis was done on intention-to-treatbasis Main outcome measures: Change in respiratory rate,Silverman-Anderson score and a Modified Pediatric Society ofNew Zealand Severity Score.Results: 14 out of 32 in nCPAP group and 5 out of 35 in standardcare group had change in respiratory rate ?10 (P=0.008). Themean (SD) change in respiratory rate [8.0 (5.8) vs 5.1 (4.0),P=0.02] in Silverman-Anderson score [0.78 (0.87) vs 0.39 (0.73),P=0.029] and in Modified Pediatric Society of New ZealandSeverity Score [2.5 (3.01) vs. 1.08 (1.3), P=0.012] weresignificantly different in the nCPAP and standard care groups,respectively.Conclusion: nCPAP helped reduce respiratory distresssignificantly compared to standard care.