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March 23, 2020

High-Flow Nasal Cannula Therapy for Pediatric Patients With Bronchiolitis: Time to Put the Horse Back in the Barn

Author Affiliations
  • 1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Pediatr. Published online March 23, 2020. doi:10.1001/jamapediatrics.2020.0040

The proliferation of observational literature on the topic of high-flow nasal cannula (HFNC) as a therapy for acute viral bronchiolitis is nothing short of remarkable. A brief PubMed search reveals a ratio of observational studies to randomized trials of at least 10 to 1 in the past 3 years alone. This proliferation suggests that, right or wrong, we have embraced the widespread use of HFNC clinically. This ratio also hints at a bigger problem, which is that we have moved on to answering somewhat peripheral questions about the therapy prior to answering the most important questions about clinical utility.

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