High‐Flow Oxygen Therapy vs. Continuous Positive Airway Pressure in Hospitalised Bronchiolitis: A Meta‐Analysis

ABSTRACT Aim To compare high‐flow oxygen therapy (HFOT) with continuous positive airway pressure (CPAP) in children with bronchiolitis aged < 24 months, using treatment failure, length of stay (LOS) in the paediatric intensive care unit (PICU), and adverse events as outcomes. Methods Systematic literature search was conducted using PubMed and Scopus until March 13, 2024. Data from prospective and retrospective studies comparing HFOT to CPAP were incorporated in the random‐effects meta‐analysis model. The results for treatment failure were presented as risk ratios (RRs) with 95% confidence intervals (95% CIs), and those for LOS in the PICU as mean differences (MD) with 95% CIs. Results Eight studies fulfilled the inclusion criteria, and one study was found by manual search. Treatment failure was less often associated with CPAP than with HFOT (RR: 0.65; 95% CI: 0.51–0.81). Instead, LOS in the PICU did not differ (standardised MD: −0.10; 95% CI: −0.27 to 0.06). Adverse events were minor being associated more often with CPAP. Conclusion Both HFOT and CPAP were safe for treating bronchiolitis, but CPAP showed a lower risk of treatment failure. Our results can be generalized to those treated in the PICU.