The Effects and Safety of Continuous Positive Airway Pressure in Children with Bronchiolitis: A Systematic Review and Meta-Analysis

J Trop Pediatr. 2021 May 17;67(2):fmaa128. doi: 10.1093/tropej/fmaa128.


Objectives: To evaluate the effects and safety of continuous positive airway pressure (CPAP) for initial respiratory management of bronchiolitis.

Methods: PubMed, EMBASE, Cochrane Library, CNKI, Wanfang data and CQ VIP were searched until 17 June 2020. Randomized controlled trials (RCTs) which investigated the effect of CPAP for bronchiolitis were included.

Results: Twenty-seven RCTs met the eligibility criteria. In the comparison of CPAP versus standard oxygen therapy, CPAP can reduce the length of stay (LOS) in hospital, respiratory rate (RR), PaCO2, heart rate, mechanical ventilation and increase PaO2, but the SpO2 and PH were not improved. In the comparison of CPAP versus high-flow nasal cannula, CPAP can reduce treatment failure, but the PICU LOS, Incidence of intubation, RR, Modified Woods Clinical Asthma Score were not decreased. Treatment failure may be less in helmet comparing with the mask though there was no quantitative analysis.

Conclusion: CPAP for the initial respiratory management significantly benefit children with bronchiolitis, the delivery of CPAP by helmet may be a better choice. More high-quality research is needed to confirm the conclusion.

Keywords: bronchiolitis; children; continuous positive airway pressure; meta-analysis; noninvasive ventilation.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bronchiolitis* / therapy
  • Cannula
  • Child
  • Continuous Positive Airway Pressure*
  • Humans
  • Oxygen Inhalation Therapy
  • Respiration, Artificial