Continuous Positive Airway Pressure versus Conventional Oxygen Therapy in the Management of Severe Bronchiolitis in Infants in Brazzaville

Introduction: Severe bronchiolitis is a major public health issue that poses challenges for healthcare in developing countries. The aim of this study was to compare the effectiveness of homemade CPAP with that of high-flow oxygen therapy using a mask in the management of severe bronchiolitis in Brazzaville. Patients and Methods: A single-blind randomized trial was conducted from October 1, 2023 to November 31, 2024, in three level 3 hospitals in Brazzaville. It involved 120 infants hospitalized for severe acute bronchiolitis. Sociodemographic, clinical, paraclinical, therapeutic, and evolutionary variables collected using a survey form were studied. Excel 2021 and Kobo Collect software were used to process and analyze the data. Results: 120 infants with a median age of 3 months [IQR: 2 - 5.75] were included. There were 75 boys and 45 girls (sex ratio = 1.7). Parents had a low socioeconomic status in 59.2% of cases. The peak frequency was noted between December and January. Homemade CPAP was used in 60 infants, with an average positive pressure of 5.4 ± 0.52 cmH2O, and oxygen therapy was used in 60 others, with an average flow rate of 13.1 liters per minute ± 1 liter. The decrease in respiratory rate was rapid in the homemade CPAP group (p = 0.025). SpO2 normalized in the CPAP group by day 1. The overall outcome was favorable in the homemade CPAP group (p = 0.027). Conclusion: Homemade CPAP is superior to conventional oxygen therapy in the management of severe bronchiolitis.