6/29/23, 1:34 AM PARIS-2 Pathway Feedback Search Clinical Topics Home Studies PARIS 2 PARIS 2 Disease Disease Bronchiolitis Community-acquired pneumonia Trial question What is the effect of early high-flow nasal oxygen therapy in hospitalized children with acute hypoxemic respiratory failure? Study design Multi-center Open label RCT Population Characteristics of study participants 48.0% female N = 1517 52.0% male 1517 patients (732 female, 785 male) Inclusion criteria: children aged 1-4 years requiring hospital admission for acute hypoxemic respiratory failure Key exclusion criteria: craniofacial abnormalities; upper airway obstruction; cyanotic heart disease; and requirement of immediate higher-level care in the ICU or noninvasive or invasive mechanical ventilation Interventions N=753 high-flow oxygen therapy (high-flow therapy with nasal cannula at weight-specific flows) N=764 standard oxygen therapy (oxygen using subnasal cannula with flows up to 2 L/min or using a Hudson face mask) https://web.pathway.md/studies/reczz5onufgiBpTuo 1/2 6/29/23, 1:34 AM PARIS-2 Pathway Primary outcome Median length of hospital stay 1.8 days 1.77 1.5 1.3 days 0.9 days 0.4 days Significant decrease 0.0 days High-flow oxygen therapy Standard oxygen therapy Significant decrease in median length of hospital stay (1.77 days vs. 1.5 days; HR 0.83, 95% CI 0.75 to 0.92) Secondary outcomes Borderline significant increase in median length of oxygen therapy (1.07 days vs. 0.75 days; HR 1.28, 95% CI 1.16 to 1.42) Borderline significant increase in escalation of care to ICU (12.5% vs. 6.9%; OR 1.93, 95% CI 1.35 to 2.75) Borderline significant increase in change in oxygen therapy in general ward or emergency department (42.9% vs. 18.5%; OR 3.42, 95% CI 2.7 to 4.34) Safety outcomes No significant difference in adverse events including death. Conclusion In children aged 1-4 years requiring hospital admission for acute hypoxemic respiratory failure, high- flow oxygen therapy was inferior to standard oxygen therapy with respect to median length of hospital stay. Reference Donna Franklin, Franz E Babl, Shane George et al. Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure The PARIS-2 Randomized Clinical Trial. JAMA. 2023 Jan 17;329(3):224-234. Open reference URL https://web.pathway.md/studies/reczz5onufgiBpTuo 2/2