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<dc:title>Incorporating a Nebulizer System Into High-Flow Nasal Cannula Improves Comfort in Infants With Bronchiolitis</dc:title>
<dc:creator>Valencia Ramos, Juan</dc:creator>
<dc:creator>Mirás, Alicia</dc:creator>
<dc:creator>Cilla, Amaia</dc:creator>
<dc:creator>Ochoa Sangrador, Carlos</dc:creator>
<dc:creator>Arnaez, Juan</dc:creator>
<dc:subject>High-flow oxygen therapy</dc:subject>
<dc:subject>Nebulization</dc:subject>
<dc:subject>Comfort</dc:subject>
<dc:subject>Bronchiolitis</dc:subject>
<dc:subject>Satisfaction</dc:subject>
<dc:subject>Jet nebulizer</dc:subject>
<dc:subject>Aerogen</dc:subject>
<dcterms:abstract>BACKGROUND:&#xd;
High-flow nasal cannula (HFNC) is increasingly used to provide respiratory support in infants with bronchiolitis. The delivery of aerosol therapy through a jet nebulizer is widely indicated despite its controversial efficacy and poor tolerability.&#xd;
METHODS:&#xd;
This randomized cross-over study aimed to evaluate the comfort and satisfaction of the delivery of aerosol therapy using a nebulization system integrated into HFNC compared with the standard practice of using a jet nebulizer with a face mask. The COMFORT-Behavior (COMFORT-B) scale, a visual analog scale, and a numeric rating scale were used by health professionals and caregivers to assess subjects' levels of comfort and satisfaction.&#xd;
RESULTS:&#xd;
A total of 113 nebulizations (64 via nebulizer with HFNC; 49 via jet nebulizer) were delivered to the 6 subjects included in the study. Use of the nebulizer with HFNC showed increased comfort and satisfaction during nebulization compared to use of the jet nebulizer, as measured by the COMFORT-B scale, the visual analog scale, and the numeric rating scale, with the following median (interquartile range) scores: 10.7 (7–16) versus 14.5 (10–20) (P = .006), 8.5 (6–10) versus 7 (4–9) (P = .02), and 3.84 (3.61–4.07) versus 1.83 (1.58–2.08) (P &lt; .001), respectively. Correlation between the COMFORT-B scale and the visual analog scale using Spearman's rho was −0.757 (P &lt; .001). The intraclass correlation coefficient for the COMFORT-B scale, visual analog scale, and numeric rating scale, as measured by 2 different nurses, was between 0.75 and 0.87.&#xd;
CONCLUSIONS:&#xd;
The use of a nebulizer incorporated into HFNC therapy results in an increased level of comfort and satisfaction compared to the use of a conventional jet nebulizer in subjects with bronchiolitis who required HFNC therapy. Further studies are needed to determine whether aerosol therapy delivered through HFNC improves the clinical course of this pathology.</dcterms:abstract>
<dcterms:dateAccepted>2025-01-27T11:53:31Z</dcterms:dateAccepted>
<dcterms:available>2025-01-27T11:53:31Z</dcterms:available>
<dcterms:created>2025-01-27T11:53:31Z</dcterms:created>
<dcterms:issued>2018</dcterms:issued>
<dc:type>info:eu-repo/semantics/article</dc:type>
<dc:identifier>0020-1324</dc:identifier>
<dc:identifier>http://hdl.handle.net/10259/10047</dc:identifier>
<dc:identifier>10.4187/respcare.05880</dc:identifier>
<dc:identifier>1943-3654</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>Respiratory Care. 2018, V. 63, n. 7, p. 886-893</dc:relation>
<dc:relation>https://doi.org/10.4187/respcare.05880</dc:relation>
<dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
<dc:publisher>María Ana Liebert</dc:publisher>
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