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Comment & Response
May 13, 2019

Treachery on the Rocks in the Pediatric Intensive Care Unit—Reply

Author Affiliations
  • 1Salesi Children’s Hospital Foundation, Ancona, Italy
JAMA Pediatr. 2019;173(7):699-700. doi:10.1001/jamapediatrics.2019.1191

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.

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