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Observational Study
. 2025 Jun;114(6):1291-1297.
doi: 10.1111/apa.17566. Epub 2024 Dec 30.

High-flow nasal cannula oxygen therapy for children with bronchiolitis: Implementation of a national guideline

Nike Beckeringh  1   2 , Rosalie S N Linssen  1   2   3 , Berber Kapitein  3 , Job B M van Woensel  3 , Frans B Plötz  1   2 ; Pediatric Research and Evaluation Network (PREN) Amsterdam study group
Collaborators, Affiliations
Observational Study

High-flow nasal cannula oxygen therapy for children with bronchiolitis: Implementation of a national guideline

Nike Beckeringh et al. Acta Paediatr. 2025 Jun.

Abstract

Aim: High flow nasal cannula (HFNC) therapy is a form of respiratory support used in children with bronchiolitis. A national guideline for the use of HFNC was published in The Netherlands in 2020. We studied the implementation and use of this guideline.

Methods: We performed a multicentre observational study amongst all hospitals in the North-West part of The Netherlands referring to the same paediatric intensive care unit (PICU). This study consisted of two parts: a comparison of local HFNC protocols to the national guideline and a survey about the use of HFNC amongst paediatricians in the participating centres.

Results: We observed considerable variations between the local protocols and the national protocol, especially regarding criteria to initiate HFNC treatment and weaning practices. Survey results showed that expectations of HFNC widely varied, while the clinical use of HFNC deviated from both the national guideline as well as local protocols, especially for weaning practices and the use of pCO2 as a parameter for initiation and evaluation of the effect of HFNC.

Conclusion: Implementation of the national guideline for HFNC therapy in bronchiolitis was inefficacious, leading to non-uniform clinical practice.

Keywords: bronchiolitis; guideline; high flow nasal cannula therapy; implementation; paediatric intensive care unit.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Weaning strategies for HFNC treatment in children with bronchiolitis.
See this image and copyright information in PMC

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