• Mercedes Bueno Campaña, Jorge Olivares Ortiz, Cristina Notario Muñoz, Marta Rupérez Lucas, Adelaida Fernández Rincón, Olga Patiño Hernández, and Cristina Calvo Rey.
• Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Comunidad de Madrid, Madrid, Spain.
• Arch. Dis. Child. 2014 Jun 1;99(6):511-5.

ObjectiveTo demonstrate that heated humidified high-flow nasal cannula (HHHFNC) is superior to inhaled hypertonic saline solution (HSS) in improving respiratory distress in moderate bronchiolitis. In addition, it could improve comfort and reduce length of hospital stay (LOS) and admission to Paediatric Intensive Care Unit (PICU).DesignRandomised Clinical Trial from 1 October 2010 to 31 December 2012.SettingTwo urban secondary (no PICU available) paediatric hospitalisation units.PatientsHospitalised children aged up to 6 months with moderate acute bronchiolitis (Respiratory Distress Assessment Instrument, RDAI ≥4).InterventionPatients were randomised to HHHFNC or HSS. All of them received epinephrine as bronchodilator.Main OutcomesPrimary outcome was difference in mean Respiratory Assessment Change Score (RACS) between both groups measured in six previously defined consecutive moments. Secondary outcomes were difference in mean comfort scores in this period, LOS and rate of PICU admission.ResultsSeventy-five previously healthy patients were enrolled. Mean age was 2.4 months (95% CI 2.04 to 2.76). 43 were allocated to HSS group and 32 in HHHFNC. Data of 1 patient were lost, and 8 changed group over the study period. Intention-to-treat principle was applied. There were no significant differences in mean RACS and mean comfort scores between groups at the evaluation points. Median LOS or PICU admission rate were similar in both groups. No adverse events were observed.ConclusionsHHHFNC was not superior to HSS in treatment of moderate acute bronchiolitis with respect to severity and comfort scores, LOS or PICU admission rate.Clinical Trial Registration Clinicaltrialsgov IdentifierNCT01873144.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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