ABSTRACT
We aimed to describe the real-life role of high-flow nasal cannula (HFNC) for bronchiolitis in infants under 3 months of age admitted to three general pediatric departments during the 2017-2018 epidemic period. We retrospectively assessed the clinical severity (Wang score) for every 24-h period of treatment (H0-H24 and H24-H48) according to the initiated medical care (HFNC, oxygen via nasal cannula, or supportive treatments only), the child's discomfort (EDIN score), and transfer to the pediatric intensive care unit (PICU). A total of 138 infants were included: 47±53 days old, 4661±851.9 g, 70 boys (50.7%), 58 with hypoxemia (42%), Wang score of 6.67±2.58, 110 (79.7%) staying for 48 consecutive hours in the same ward. During the H0-H24 period, only patients treated with HFNC had a statistically significant decrease in the severity score (n=21/110; -2 points, P=0.002) and an improvement in the discomfort score (n=15/63; -3.8 points, P<0.0001). There was no difference between groups during the H24-H48 period. The rate of admission to the PICU was 2.9% for patients treated for at least 24 h with HFNC (n=34/138, 44% with oxygen) versus 16.3% for the others (P=0.033). Early use of HFNC improves both clinical status and discomfort in infants younger than 3 months admitted for moderately severe bronchiolitis, whatever their oxygen status.
Subject(s)
Bronchiolitis/therapy , Oxygen Inhalation Therapy/methods , Acute Disease , Bronchiolitis/diagnosis , Cannula , Female , Hospital Departments , Hospitalization , Humans , Infant , Infant, Newborn , Male , Oxygen Inhalation Therapy/instrumentation , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
The pediatrician training system includes four levels of construction mode:the pediatric professional training for general practitioner, general pediatric professional training, pediatric skills training of community in-service physicians and pediatric continuing education for general pedestrians by Pediatric Professional Committee. Standardized and homogeneous training will help to improve children's health service system and change the current shortage of pediatric clinicians at the primary level.
