Physiologic effect of high-flow nasal cannula in infants with bronchiolitis

Pediatr Crit Care Med. 2014 Jun;15(5):e214-9. doi: 10.1097/PCC.0000000000000112.


Objective: To assess the effect of delivering high-flow nasal cannula flow on end-expiratory lung volume, continuous distending pressure, and regional ventilation distribution in infants less than 12 months old with bronchiolitis.

Design: Prospective observational clinical study.

Setting: Nineteen bed medical and surgical PICU.

Patients: Thirteen infants with bronchiolitis on high-flow nasal therapy.

Interventions: The study infants were measured on a flow rate applied at 2 and 8 L/min through the high-flow nasal cannula system.

Measurements and results: Ventilation distribution was measured with regional electrical impedance amplitudes and end-expiratory lung volume using electrical impedance tomography. Changes in continuous distending pressure were measured from the esophagus via the nasogastric tube. Physiological variables were also recorded. High-flow nasal cannula delivered at 8 L/min resulted in significant increases in global and anterior end-expiratory lung volume (p < 0.01) and improvements in the physiological variables of respiratory rate, SpO2, and FIO2 when compared with flows of 2 L/min.

Conclusion: In infants with bronchiolitis, high-flow nasal cannula oxygen/air delivered at 8 L/min resulted in increases in end-expiratory lung volume and improved respiratory rate, FIO2, and SpO2.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pressure
  • Bronchiolitis / physiopathology
  • Bronchiolitis / therapy*
  • Continuous Positive Airway Pressure
  • Electric Impedance
  • Esophagus
  • Female
  • Humans
  • Infant
  • Lung Volume Measurements
  • Male
  • Oxygen / administration & dosage
  • Oxygen / blood*
  • Oxygen Inhalation Therapy / methods*
  • Prospective Studies
  • Pulmonary Ventilation / physiology*
  • Respiratory Rate


  • Oxygen