RT Journal Article SR Electronic T1 Efficacy and safety of high flow nasal oxygen for children with bronchiolitis: systematic review and meta-analysis JF BMJ Open Respiratory Research JO BMJ Open Resp Res FD British Thoracic Society SP e000844 DO 10.1136/bmjresp-2020-000844 VO 8 IS 1 A1 Carwyn Dafydd A1 Benjamin J Saunders A1 Sarah J Kotecha A1 Martin O Edwards YR 2021 UL http://bmjopenrespres.bmj.com/content/8/1/e000844.abstract AB Background To assess the published evidence to establish the efficacy and safety of high flow oxygen cannula (HFNC) as respiratory support for children up to 24 months of age with bronchiolitis within acute hospital settings.Methods We searched eight databases up to March 2021. Studies including children up to 24 months of age with a diagnosis of bronchiolitis recruited to an randomised controlled trial were considered in the full meta-analysis. At least one arm of the study must include HFNC as respiratory support and report at least one of the outcomes of interest. Studies were identified and extracted by two reviewers. Data were analysed using Review Manager V.5.4.Results From 2943 article titles, 308 full articles were screened for inclusion. 23 studies met the inclusion criteria, 15 were included in the metanalyses. Four studies reported on treatment failure rates when comparing HFNC to standard oxygen therapy (SOT). Data suggests HFNC is superior to SOT (OR 0.45, 95% CI 0.36 to 0.57). Four studies reported on treatment failure rates when comparing HFNC to continuous positive airways pressure (CPAP). No significant difference was found between CPAP and HFNC (OR 1.64, 95% CI 0.96 to 2.79; p=0.07). Four studies report on adverse outcomes when comparing HFNC to SOT. No significant difference was found between HFNC & SOT (OR 1.47, 95% CI 0.54 to 3.99).Conclusion HFNC is superior to SOT in terms of treatment failure and there is no significant difference between HFNC and CPAP in terms of treatment failure. The results suggest HFNC is safe to use in acute hospital settings.All data relevant to the study are included in the article or uploaded as online supplemental information. All data relevant to the study are included with the article.