Heated Humidified Oxygen Compared to Dry Oxygen Therapy in Children With Bronchiolitis

Bronchiolitis is the leading cause of acute respiratory illness and hospitalization in
infants and young children. The mainstay of treatment is supportive care, which includes
frequent nasal suctioning, intravenous fluid hydration, and supplemental oxygen for
hypoxemia.

The airways normally heat and humidify inspired ambient air to core temperature amd 100%
relative humidity at the carina. This environment, at core temperature, allows for optimal
mucociliary clearance. Supplemental oxygen delivered via wall source is cold and dry, and
does not reach core temperature and 100% humidity until some point distal to the carina, past
the main bronchi. This presses on the lower respiratory tract to assist in heat and moisture
exchange and thus decrease ciliary function. This, in combination with bronchiolitis, can
impair mucociliary clearance.

Specific aim 1: Determine the effect of heated and humidified oxygen therapy on clinical
improvement in children with bronchiolitis, based on Respiratory Distress Assessment
Instrument (RDAI) and respiratory rate (RR).

Specific aim 2: Determine the effect of heated and humidified oxygen therapy on length of
hospital stay and duration of supplemental oxygen requirement in children with bronchiolitis.

Inclusion Criteria:

- Ages ≤24 months of age

- Physician diagnosed bronchiolitis

- Admitted to pediatric floor

- Supplemental oxygen requirement, <4 L/min, for hypoxemia, oxygen saturation <92% in
room air

Exclusion Criteria:

- Prematurity, born <37 weeks gestational age

- Admitted to pediatric intensive care unit for medical indication

- Requirement of heated, humidified high flow system

- Chronic lung disease (such as bronchopulmonary dysplasia, cystic fibrosis, primary
ciliary dyskinesia, tracheostomy status, baseline oxygen requirement)

- Neuromuscular disorders

- Chromosomal defects

- Metabolic disorders

- Immunodeficiency

- Unrepaired cardiac abnormalities