Please select the eligibility criteria that correspond to the clinical trial below.
Title: Comparison of High Flow Oxygenation Therapy and CPAP in Children With Bronchiolitis.
Brief Summary: Bronchiolitis in infants and young children often requires respiraty support. In Denmark Continous Positive Airway Pressure ( CPAP) are routinely used in children with moderate-severe bronchiolitis. The aim of the study is to compare CPAP and High Flow Oxygenation Therapy (HFOT) as tools of respiratory support in infants and young children with bronchiolitis.

Infants and young children with moderate-severe bronchiolitis and are randomized to either CPAP or HFOT.


Options:
A: Inclusion Criteria:

Eligible patients will fall into one of two groups:

Group A (Step-up)

1. Age \>36 weeks corrected gestational age and \<16 years, AND
2. Deemed to require non-invasive respiratory support by the treating clinician for an acute illness, AND
3. Satisfies one or more of the following criteria:

   * Hypoxia (oxygen saturation \<92% in fraction of inspired oxygen (FiO2) \>0.40, or equivalent). FiO2 of 0.40 roughly equates to standard unhumidified nasal cannula oxygen delivered at 6 L/min or oxygen delivered via facemask without a rebreather bag at 6-10 L/min.
   * Acute respiratory acidosis (pH \<7.3 with a concomitant pCO2 \>6.5 kPa)
   * Moderate respiratory distress (use of accessory muscles, subcostal and intercostal recession, tachypnoea for age, grunting)

Group B (Step-down)

1. Age \>36 weeks corrected for gestation and \<16 years, AND
2. Deemed to require non-invasive respiratory support by the treating clinician after extubation, following a spell of invasive ventilation

   * Either immediately after extubation as a 'planned' procedure, irrespective of clinical condition ('planned') OR
   * Prompted by deterioration in clinical condition within 72 hours after extubation ('rescue'). Clinical parameters to assess the need for NRS in this situation will be similar to point 3 in Group A.

Exclusion Criteria:

1. Deemed by the treating clinician to require immediate intubation/invasive ventilation due to severe hypoxia, acidosis and/or respiratory distress, upper airway obstruction or recurrent apnoeas
2. Tracheostomy in place
3. Pre-existing air-leak syndrome (pneumothorax/pneumomediastinum)
4. Midfacial/craniofacial anomalies (unrepaired cleft palate, choanal atresia) or had recent craniofacial surgery
5. Agreed limitation of intensive care treatment plan in place ('not for intubation')
6. On domiciliary non-invasive ventilation prior to PICU admission
7. Managed on either HFNC and/or CPAP (or other form of non-invasive ventilation such as BiPAP) in the preceding 24 hours
8. Previously recruited to this study during the same PICU admission
9. Cannot be treated with HFNC

   * Unavailability of appropriate sized nasal prongs
   * Unavailability of HFNC device
10. Cannot be treated with CPAP

    * Unavailability of right size of face mask, prong or other patient interface
    * Unavailability of CPAP device
B: Inclusion Criteria:

* Age: 0-18 months
* Mechanical Ventilation via an endotracheal tube
* Elective surgery
* Post-bypass procedure
* Rachs 2 and above

Exclusion Criteria:

* Presence of major congenital malformations
* Presence of neuromuscular disease
* Presence of non drained pneumothorax
* Absent respiratory drive or recurrent apneas
* Hemodynamic instability
* Glasgow coma score (GCS) less than 8
* ECG with evidence of ischaemia or arrhythmias
* Active bleeding
C: Inclusion Criteria:

* infants and children with moderate respiratoric syncytial virus bronchiolitis or other viral bronchiolitis and need of respiratory support. ( clinical decision)

Exclusion Criteria:

* severe bronchiolitis with P C02 \> 9, decreased consciusness and risk for early progression to intensive therapy.
D: Inclusion Criteria:

* Minimum age: 18 years
* planned extubation decided by the physician in charge of the patient after success of weaning trial
* patients at high risk of reintubation according to the following criteria: patient older than 65 years, or those having any underlying chronic cardiac or lung disease
* Hypoxemia defined by PaO2/FiO2 \< 300 mmHg under mechanical ventilation before extubation

Exclusion Criteria:

* Duration of mechanical ventilation prior to extubation \< 24h
* Contraindication to NIV
* Contraindication to nasogastric tube
* Do-not-reintubated order at time of extubation
* People under legal protection
* Opposition to participate

Answer: C