High Flow Nasal Cannula Therapy for Bronchiolitis Across the Emergency Department and Acute Care Floor

Bronchiolitis is among the most common pediatric illnesses, and accounts for a significant burden of disease for children and families with large economic burden on the United States healthcare system. Although bronchiolitis is extremely common, treatment is varied with little foundational evidence for best practices. In the past decade the use of high flow nasal cannula (HFNC) has increased in use in children with acute respiratory conditions including bronchiolitis. Multiple studies of patients in the intensive care unit (ICU) have shown that initiation of HFNC therapy has led to decreased intubation rates. Institutions around the country have implemented local protocols on using HFNC for bronchiolitis on the pediatric acute care floor but there is little literature that supports this use. We aim to provide a review of the literature on the efficacy of HFNC and share experiences with its use outside the ICU on acute care floors.