{
  "abstract": "Introduction Bronchiolitis represents one of the most common respiratory tract infections and a common cause of hospital and PICU admission. Paediatric patients with bronchiolitis may require respiratory support during admission. This study systematically reviewed and compared clinical effectiveness and safety of different respiratory support modalities (HFNC, LFNC, CPAP) in paediatric patients ≤24-months-old with bronchiolitis.Methods A literature search on PubMed, Scopus, Cochrane library, Embase and CINAHL was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted by two reviewers, and a random effect model was used to estimate pooled effects. Risk of bias was assessed using the Collaboration’s Risk of Bias for Randomized trials-2 (RoB-2) tool.Results Of the 5,636 non-duplicate studies, eighteen studies with 4,094 paediatric patients ≤24-months-old with bronchiolitis were included. Twelve studies compared HFNC to LFNC including data for 3,273 patients (HFNC (n=1,633) and LFNC (n=1640)) and six studies with 821 patients compared the use of HFNC (n=415) versus CPAP (n=406).Use of HFNC did not reduce the need for mechanical ventilation compared to LFNC (P = 0.32) or CPAP (P = 0.52). HFNC resulted in less treatment failure (RR 0.44, 95% CI 0.23 to 0.87, I2=92%, P = 0.02) and a significant reduction in length of PICU stay compared to LFNC (Mean Difference (MD) -0.40 95% CI -0.78 to -0.02, I2=85%, P = 0.04) but not compared to CPAP (RR 1.28, 95% CI 0.90 to 1.80, P = 0.17) and (MD -0.24, 95% CI -0.91 to 0.43, I2=0%, P = 0.47) respectively. respectively. HFNC reduced the total oxygen therapy duration compared to LFNC (MD -0.37 95% CI -0.63, -0.12, I2=81%, P = 0.004). There were no differences between HFNC and CPAP group in secondary outcomes.Conclusion HFNC was associated with significantly reduced treatment failure, length of PICU stay and total oxygen therapy duration compared to LFNC. There were no differences between HFNC and CPAP regarding clinical outcomes. Results of this meta-analysis shows that HFNC may be considered as initial treatment modality in paediatric patients with bronchiolitis requiring respiratory support especially as a step-up in patients that do not improve with LFNC. *presenting author",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London E1 2AT, UK",
        "First Department of Pediatrics, Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece"
      ],
      "name": "Spyridon Karageorgos"
    },
    {
      "affiliations": [
        "Department of Pediatric Respiratory Medicine, Evelina London Children’s Hospital, London, UK"
      ],
      "name": "Anastasios Panagiotis Chantzaras"
    },
    {
      "affiliations": [
        "Library and Information Service, Children’s Health Ireland, Dublin, Ireland"
      ],
      "name": "Nicola O’Shea"
    },
    {
      "affiliations": [
        "Research and Innovation, Children’s Health Ireland, Dublin, Ireland"
      ],
      "name": "Aidan Beegan"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London E1 2AT, UK"
      ],
      "name": "Tessa Davis"
    },
    {
      "affiliations": [
        "Paediatric Emergency Research and Innovation (PERI), Department of Paediatric Emergency Medicine, Children’s Health Ireland, D12 N512 Dublin, Ireland",
        "Women’s and Children’s Health, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland"
      ],
      "name": "Michael Barrett"
    }
  ],
  "title": "#107 Respiratory support in paediatric patients with bronchiolitis: a systematic review and meta-analysis",
  "uid": "ed6af051-fe89-51b8-8e81-c94b436add19"
}