Analysis of predictors of response to high-flow oxygen nasal cannula therapy in a pediatric intensive care unit

Background: Bronchiolitis is one of the most frequent reasons for admission to pediatric intensive care units. Medical treatment is primarily supportive. The usefulness of high-flow oxygen (HFO) nasal cannula in these patients has been described. This study evaluated the clinical and analytical variables of patients admitted to our Pediatric Intensive Care Unit (PICU) for initiation or continuation of HFO for respiratory distress and to identify any variable that may be a predictor of success or failure of this technique. Methods: We conducted a retrospective observational study that included infants aged < 24 months admitted to our PICU due to bronchiolitis between January 2015 and March 2019 for HFO. Results: We analyzed the characteristics between responders (n = 112) and non-responders (n = 37). No statistically significant differences were observed between groups regarding sex, age, weight, comorbidities, nasopharyngeal aspirate result, hours of evolution, and respiratory and heart rate. However, a pCO2 ≥ 75 mmHg (p = 0.043) and a SCORE of bronchiolitis severity (p = 0.032) were predictors of HFNC failure. Conclusions: The pCO2 level and SCORE of bronchiolitis severity are predictors of this respiratory support modality.