WIP 70 - Establishing the timeframe for safe discharge in patients admitted for bronchiolitis treated with high flow nasal cannula

Publication Number: WIP 70.7378

Elise G. Hon, Cohen Children's Medical Center, Forest Hills, NY, United States; Varsha Sarma, Cohen Children's Medical Center, Bellerose, NY, United States; Luke V. Maffei, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, United States; Joanna Fishbein, Northwell Health, Plainview, NY, United States; Ann Le, Cohen’s Children Medical Center, New Hyde Park, NY, United States

Background: Bronchiolitis is a lung infection involving the lower respiratory tract that can present with a wide spectrum of disease, and is the leading cause of hospitalizations in children < 2 years old. High flow nasal cannula (HFNC) has been widely embraced as a mainstay treatment of bronchiolitis on the general pediatric floors given its simplicity, tolerability, and safety. However, there is currently a lack of consistent clinical guidelines regarding the monitoring of patients once weaned off HFNC and thus the optimal monitoring period before discharge is still unclear.

Objective: This study aims to determine the timeframe in which patients being treated for bronchiolitis requiring respiratory support in the form of HFNC can be safely discharged from the hospital upon being weaned to room air (RA) with minimal risk of requiring additional respiratory support. To establish this timeframe, we aim to examine the time to requiring additional respiratory support (either HFNC or low flow nasal cannula) after being weaned to RA for those patients who did not tolerate the initial wean. By better characterizing the time to requiring additional respiratory support after being weaned to RA, it can help inform the optimal period patients should be monitored in the hospital before discharged.

Design/Methods: An IRB approved single center, retrospective chart review of otherwise healthy patients between the ages of 2 months and 2 years old admitted to the general pediatric wards in a tertiary children’s hospital treated for viral bronchiolitis with HFNC from 2018 to 2023 will be performed. The primary outcome is the time to requiring additional respiratory support after the patient has been weaned to RA. Secondary outcomes include length of stay, time to discharge on RA, and ED visits and readmission rates within 3 and 7 days of discharge. We plan to use logistic regression to determine significant predictors of binary outcomes and standard methods for survival analysis to assess the time to additional respiratory intervention. We aim to complete data analysis and interpretation by Jan 2025.