Hofman, R. (Roy) (2019) Hoge flow zuurstofsuppletie bij kinderen met bronchiolitis niet effectiever dan lage flow in verlichten van dyspnoe: een multicenter gerandomiseerde gecontroleerde studie. thesis, Medicine.
Full text available on request.Abstract
Background Oxygen therapy is an important part of the symptomatic treatment of bronchiolitis in young children. Currently, low flow oxygen therapy (LF) is the standard, but high flow oxygen therapy (HF) has been used increasingly in recent years. Aim Our aim was to study the effects HF in comparison to LF in children with moderately severe dyspnea due to bronchiolitis, focusing on the degree of dyspnea, comfort, duration of stay, duration of oxygen therapy, ICU transfer and tube feeding. Methods Multicenter randomized controlled trial. In five hospitals (Amphia, Deventer, Ikazia, Isala, Martini), children <2 years of age admitted with a bronchiolitis with oxygen demand and a PEWS ≥6 were randomized for HF or LF in three winter seasons (December 2016 - March 2019). We analyzed the effects within 24 hours on the PEWS as a measure for dyspnea and FLACC as a measure for comfort, and in the longer term on the length of stay, duration of oxygen therapy, ICU transfer and need for tube feeding. Results Until March 1, 2019, 79 patients were randomized to HF (n=38) or LF (n=41). No statistically significant difference was found in the proportion of patients with a decrease in PEWS ≥2 (74% vs. 78%, difference 4%, 95% confidence interval -16% to 24%, p=0.692). Also, in admission time (4.7 vs. 4.0 days, p=0.638), duration of oxygen therapy (3.2 vs. 2.6 days, p=0.263), ICU transfer (16% vs. 12%, p=0.610) and need for tube feeding (78% vs. 68%, p=0.316) no statistically significant difference was seen. The median FLACC score in the HFgroup showed a statistically significant difference to the LF-group (0 vs. 1, median difference 0, 95% confidence interval -1 to 0, p=0.031), but was not clinically relevant. Conclusion HF does not seem to offer any advantages over LF in the Dutch setting in children with moderately-severe bronchiolitis with oxygen demand.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Bekhof, Dr. J. |
| Supervisor name: | Tweede begeleider: and Kooiman, Drs. L.M.P. and Centrum: Isala Ziekenhuis and Afdeling: Kindergeneeskunde and Plaats: Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1363 |
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