Comparison of salbutamol and high-flow nazal cannulated oxygen treatments in children with acute bronchiolite

In this prospective intervention study conducted in the Pediatric Emergency Clinic; Salbutamol and YANKOT were administered to healthy children <2 years of age who presented with the first bronchiolitis attack and had SKS 4; clinical results were compared. 47 of 72 patients were male, mean age was 7.8 months, 59.7% of them were <6 months. 52 (72.2%) were born by cesarean section, 65% were breastfed only in the first six months, 16.7% had food allergy / eczema, 39 had domestic cigarette smoke exposure, 29 had family members and 97.2% had asthma. Their mothers were caring for them, 33.3% of them lived in a crowded family. The most common complaint was cough (68.1%). The most common tachycardia (72.2%), tachypnea (84.8%), desaturation (SaO2 <95%, 22.2%) and fever (12.5%) were detected, 79.2% of them had no findings other than the SKS parameters in their examinations. The mean SKS at admission was 8.4 points, and the proportion of patients in moderate and severe clinic was equal. Most (85%) of those with severe bronchiolitis were children of low-income families (p0.004). The mean scores of SKS and its sub-parameters decreased significantly from the first hour (p <0.05). Mean respiration and heartbeat / min numbers regressed to normal after the 4th hour, there was a moderate negative correlation between the patient's age and weight and SKS (p <0.05). While 44.4% were discharged in the first 8 hours, 51.4% were hospitalized in the service and 4.2% were hospitalized in intensive care. Those aged <3 months were hospitalized more often (p: 0.007). The average duration of hospitalization and oxygen therapy was 70 and 67 hours. In the first 7 days after discharge, 50% of the patients presented with respiratory complaints. In the twenty-month follow-up, 59% of them had bronchiolitis again. In this respect, being male and going to the nursery made a significant difference (p <0.05). The groups, except that those in the YANKOT group were mostly from large families (p: 0.011); They were similar in terms of sociodemographic and clinical characteristics. The mean SKS with treatment showed difference in favor of the YANKOT group starting from the second hour. Significant differences were found between the groups in heart rate starting from the 1st hour and respiratory rate at the 8th hour. While the pulse decreased below 150 / min and respiratory rate below 50 / min at the 1st hour in the YANKOT group, it decreased after the 4th hour in the salbutamol group. While the expected improvement was not observed in 17.1% of the patients who took salbutamol, YANKOT should be added to the treatment within 2-4 hours, while no treatment change was required in the YANKOT group. Patients who received YANKOT alone and YANKOT were added to salbutamol had higher rates of hospitalization (p: 0.017), longer periods of hospitalization (p: 0.002) and oxygen therapy (p: 0.001) compared to those who received salbutamol. Re-admission to the hospital in 7 days after discharge; It was 64.2% in the salbutamol group, not in the YANKOT group (p: 0.000). Comfort score was 13.9 points on average in 33 patients, and there was no difference between the groups. There were no complications related to the treatments in any patient. With the results of this study, which can be done with a limited number of patients; It can be said that YANKOT creates earlier and faster clinical improvement in babies presenting with the first acute bronchiolitis attack of moderate-severe clinical severity and is at least as effective and safe as salbutamol in terms of dyspnea and retraction findings.