High Flow Nasal Cannula Oxygen Therapy and Length of Stay in Bronchiolitis

¹Junior Medical Officer, Royal Prince Alfred Hospital & Former Medical Student, Paediatrics and Child Health, School of Medicine, Western Sydney University, Australia
²Staff Specialist Paediatrician, Blacktown and Mt Druitt Hospitals, Australia
³Research Statistician, Reproduction and Perinatal Centre & Western Sydney Local Health District, Westmead, Australia
⁴Former Paediatric Clinical Nurse Consultant, Blacktown and Mt Druitt Hospitals, Australia
⁵Senior Staff Specialist, Blacktown and Mt Druitt Hospitals & Paediatrics and Child Health, School of Medicine, Western Sydney University, Australia
⁶Staff Specialist Paediatrician, Blacktown and Mt Druitt Hospitals & Paediatrics and Child Health, School of Medicine, Western Sydney University, Australia
⁷Medical Registrar, Liverpool Hospital, Former Medical Student, Paediatrics and Child Health, School of Medicine, Western Sydney University, Australia
⁸Senior Clinical Analyst, Western Sydney Local Health District, Cumberland Hospital, Australia
⁹Senior Staff Specialist, Blacktown and Mt Druitt Hospitals & Paediatrics, School of Medicine, Western Sydney University, Australia

*Corresponding Author: Dr. Jamesha Kaibav, Junior Medical Officer, Royal Prince Alfred Hospital & Former Medical Student, Paediatrics and Child Health, School of Medicine, Western Sydney University, Locked Bag 1797 Penrith NSW 2751, Australia, Phone: 0439408167, Emails: [email protected]; [email protected]

Received Date: May 19, 2026
Published Date: June 26, 2026

Citation: Kaibav J, et al. (2026). High Flow Nasal Cannula Oxygen Therapy and Length of Stay in Bronchiolitis. Mathews J Pediatr. 11(1):51.

Copyright: Kaibav J, et al. © (2026).

ABSTRACT

Background: Recent meta-analyses on the treatment of bronchiolitis with high flow nasal cannula oxygen therapy (HFNC) therapy suggest its utility as rescue therapy. Evidence of the effect of HFNC on length of stay (LOS) is variable. This study explored LOS and interhospital transfer to tertiary referral centres as HFNC was introduced to a peripheral paediatric unit in a metropolitan hospital. It also compared LOS associated with HFNC vs non-HFNC management overtime. Methods: This retrospective single centre study collected data from 2457 cases of bronchiolitis presentations over three distinct epochs; before (Epoch 1), during (Epoch 2), and after (Epoch 3) the establishment of HFNC as a routine therapy for bronchiolitis in infants attending a peripheral metropolitan hospital. Results: LOS overall increased with HFNC introduction, however transfer rates to tertiary referral centres did not change significantly over time. Furthermore, LOS was greater for those who received HFNC than non-HFNC (IRR of 1.83; 1.71 – 1.96; p < 0.01), and transfer rates were higher for patients receiving HFNC than not in both Epoch 2 and 3. Conclusions: Considering the now established utility of HFNC as rescue therapy, the increasing LOS and unchanged transfer rates observed with the introduction of HFNC may reflect the impact of clinician caution with  slower weaning rates, particularly in a peripheral paediatric centre. Future research should investigate the role of clinician judgment in HFNC initiation and weaning.

Keywords: Bronchiolitis, High Flow, Oxygen Therapy, Nasal Cannula, Infant, Length of Stay.