{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:58:28Z","timestamp":1790600308275,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005627","name":"Thrasher Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005627","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>High\u2010flow is increasingly used in children with acute hypoxaemic respiratory failure (AHRF), despite limited evidence. The primary feasibility endpoint for this pilot\u2010study was the proportion of treatment failure, secondary outcomes being intensive care unit (ICU) admissions and proportion of patients requiring escalation of care. We measured duration of hospital stay, duration of oxygen therapy and rates of ICU admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An open\u2010labelled randomised controlled trial feasibility design was used in two tertiary children's hospitals in the emergency department and general wards. Children aged 0\u201316\u2009years with AHRF were randomised (1:1) to either high\u2010flow or standard\u2010oxygen. Children on standard\u2010oxygen received rescue high\u2010flow in general wards if failure criteria were met.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 563 randomised, 283 received high\u2010flow and 280 standard\u2010oxygen with no adverse events. The proportion of children who failed treatment and receiving escalation of care was 11.7% (32\/283 children) on high\u2010flow and 18.1% (50\/280 infants) on standard\u2010oxygen (odds ratio 0.68, 95% confidence interval 0.38\u20131.00). In children with obstructive airway disease, 9.7% on high\u2010flow and 17.4% on standard\u2010oxygen required escalation (risk\u2010difference \u22127.7% percentage points; 95% confidence interval \u221214.3, \u22121.1); in children with non\u2010obstructive disease no difference was observed. Neither difference in ICU admissions nor any difference in length of hospital stay was observed. Sixty percent of children who failed standard\u2010oxygen responded to rescue high\u2010flow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010flow outside ICU appears to be feasible in children with AHRF and the required proportion of escalation was lower compared to standard\u2010oxygen. The trial design can be applied in a future large randomised controlled trial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15259","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T21:18:12Z","timestamp":1609363092000},"page":"273-281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["High flow in children with respiratory failure: A randomised controlled pilot trial \u2013 A paediatric acute respiratory intervention study"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-3270","authenticated-orcid":false,"given":"Donna","family":"Franklin","sequence":"first","affiliation":[{"name":"Gold Coast University Hospital Emergency Department Collaborative Research Group  Southport Australia"},{"name":"The University of Queensland, Paediatric Critical Care Research Group Child Health Research Centre, School of Medicine  South Brisbane 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Melbourne Victoria Australia"},{"name":"Emergency Department Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Emergency Research Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikki","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Australia"},{"name":"Paediatric Emergency Department Children's Health Queensland and Health Services  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Williams","sequence":"additional","affiliation":[{"name":"PREDICT (Paediatric Research in Emergency Departments International Collaborative)  Parkville Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Emergency Department Royal Children's Hospital  Melbourne Victoria 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Queensland, Paediatric Critical Care Research Group Child Health Research Centre, School of Medicine  South Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang MT","family":"Pham","sequence":"additional","affiliation":[{"name":"The University of Queensland, Paediatric Critical Care Research Group Child Health Research Centre, School of Medicine  South Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Acworth","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Australia"},{"name":"PREDICT (Paediatric Research in Emergency Departments International Collaborative)  Parkville Victoria Australia"},{"name":"Paediatric Emergency Department Children's Health Queensland and Health Services  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Levitt","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Australia"},{"name":"Department of Paediatrics Children's Health Queensland and Health Services  South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Oakley","sequence":"additional","affiliation":[{"name":"PREDICT (Paediatric Research in Emergency Departments International Collaborative)  Parkville Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Emergency Department Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Emergency Research Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schibler","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Australia"},{"name":"The University of Queensland, Paediatric Critical Care Research Group Child Health 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