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Use of continuous positive airway pressure during stabilisation and retrieval of infants with suspected bronchiolitis

Authors


  • Conflict of interest: None declared.

  • Institution where work was undertaken: NETS Vic, The Royal Women's Hospital, Parkville, Victoria, Australia.

Dr Paul Fleming, Centre for Paediatrics, Blizzard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, 4 Newark Street, London E12AT, UK. Fax: +44 2 07 943 1382; email: drpaulfleming@gmail.com

Abstract

Aim:  Infants with viral bronchiolitis are often hospitalised with a proportion requiring respiratory support. The aim of this review was to examine the use of nasal prong continuous positive airway pressure (CPAP) as a management strategy for infants with a diagnosis of bronchiolitis, who required stabilisation and transport to a tertiary centre.

Method:  A retrospective audit of infants with bronchiolitis requiring CPAP during transport between January 2003 and June 2007.

Results:  Nasal CPAP was initiated in 54 infants with 51 of these (34 ex-preterm, 17 term) subsequently continuing on CPAP during retrieval. Mean CPAP pressure was 7 cmH2O. Oxygenation improved between stabilisation and the end of retrieval (P < 0.01). During retrieval, there was no significant increase in transcutaneous CO2, no infant required endotracheal ventilation and no adverse events were noted. Five infants were intubated within the first 24 h of admission at the receiving hospital.

Conclusion:  This review demonstrated that use of nasal prong CPAP to transport infants with bronchiolitis was a safe management strategy in those with moderate to severe disease severity.

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