Bronchiolitis – HFNC — RACP Paediatrics MCQ

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ModerateRespiratoryBronchiolitis – HFNCRACP Paediatrics

A 3-month-old with bronchiolitis has SpO2 of 90% with moderate work of breathing. Nasal cannula at 2 L/min has not improved saturations. The infant is still managing nasogastric feeds. What is the most appropriate next step for respiratory support?

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Correct answer: D — High-flow nasal cannula (HFNC)

High-flow nasal cannula (HFNC) is increasingly used as first-line escalation in bronchiolitis when standard oxygen therapy is insufficient. It provides heated humidified oxygen at flows of 2 L/kg/min (up to 25 L/min in infants). Per the Australasian Bronchiolitis Guideline 2025, HFNC reduces work of breathing and may reduce the need for PICU admission.

Reference: PREDICT Network – 2025 – Australasian Bronchiolitis Guideline; RCH Melbourne – 2023