Salbutamol Plus Mask Oxygen Versus HFNC in Bronchiolitis

Introduction: As the benefit of many pharmacologic treatments for bronchiolitis is a source of debate, investigations of more effective, easy-to-apply treatment modalities of acute bronchiolitis remain up-to-date. Methods: In this study, nebulised salbutamol plus standard oxygen (S) and HFNC (HF) therapies were administered to children younger than two years of age, with a respiratory clinical score (RCS) ≥4 points, who presented with a first episode of acute bronchiolitis. Results: The mean age of 72 patients was 7.8±0.4, and 59.7% were younger than six months. The mean RCS of the patients at admission was 8.42±2.026 points. A significant decrease was observed in the mean RCS scores evaluated at 1-2-4-8 hours, from the first hour (p<0.05). The mean length of hospital stay and duration of oxygen therapy were 70±64.6 (4-288) and 67.7±62.2 (4-264) hours. Within the first few days after discharge, 50% of the patients returned to the pediatric emergency department (PED). The mean RCS showed a difference in favour of the HF group from the second hour of treatment (p=0.002). Expected improvement was not observed in 17.1% of the patients in the S group only, thus HF should be added. Patients in the HF group and patients in whom HF was added to S had higher hospitalisation rates (p=0.017), longer hospital stays (p=0.002), and longer duration of oxygen therapy (p=0.001). Re-admission to PED after discharge was observed in 64.2% of the cases in the S group only (p<0.001). Conclusion: In this study, it may be said that HFNC treatment provides earlier and faster clinical improvement in children with bronchiolitis and reduces re-admissions related to the same disease.