In Reply Nasal oxygen therapy is part of routine care in bronchiolitis, and delivery incorporates high-flow oxygen (HFO) and continuous positive airway pressure (CPAP). In their comment on the fascinating “song of the sirens,” that is, indiscriminate use of HFO in children with bronchiolitis,1 Pons-Odena et al state that this treatment may be even more treacherous in the pediatric intensive care unit. They suggest that CPAP should be considered the first-line treatment in patients with moderate-to-severe bronchiolitis in substitution of HFO therapy. Although the primary aim of the original article was not to compare methods of noninvasive ventilation, some aspects need to be addressed.
de Benedictis FM. Treachery on the Rocks in the Pediatric Intensive Care Unit—Reply. JAMA Pediatr. 2019;173(7):699–700. doi:10.1001/jamapediatrics.2019.1191
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