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High-flow nasal cannula protocol reduces length of stay, hospital charges for pediatric patients with bronchiolitis

Pediatric patients admitted to the intensive care unit for treatment of bronchiolitis had reduced length of stay and decreased total hospital charges after the implementation of a high-flow nasal cannula protocol, according to recent research.

“We found implementation of this protocol was associated with both reduced total [length of stay (LOS)] and total hospital charges for patients with bronchiolitis initially admitted to the [pediatric intensive care unit (PICU)],” Jeffrey Riese, MD, from the Hasbro Children’s Hospital in Providence, Rhode Island, and colleagues wrote. “Additionally, we found that weaning of [high-flow nasal cannula (HFNC)] was faster during the second time period when HFNC was available on the wards.”

Riese and colleagues compared the effects of switching to a high-flow nasal cannula protocol had on 290 pediatric patients both 24 months before and after implementation in a pediatric intensive care unit, according to the abstract. The researchers compared length of stay in the pediatric ICU as well as the effects of implementation on 30-day readmission, hospital charges and intubation.

They found that the 170 patients admitted after implementation of high-flow nasal cannula had a lower length of stay (4 days vs. 3 days; P < .001) as well as lower hospital charges ($12,257 vs. $9,337; P < .001), according to the abstract.

“The reduced total hospital charges are entirely attributed to the shorter total LOS in the after group,” Riese and colleagues wrote. “Although LOS is the main driver of reduced total hospital charges, it is nonetheless notable.”

However, there was no significant difference between patient groups regarding 30-day readmission or rate of intubation. Of the patients who were present in the pediatric ICU prior to implementation, Riese and colleagues noted that 30% were transferred to the wards after implementation. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.