The Effectiveness of Heated Humidified High-flow Nasal Cannula in Children with Severe Bacterial Pneumonia in the Emergency Department

Introduction Severe bacterial pneumonia (SBP) is a common lifethreatening disease for pediatric population, and is more common in infants and young children (1). Respiratory distress (RD) due to SBP is one of the most common causes of emergency department (ED) admissions (1-3). Every year, it causes over 500000 ED visits in the USA and over 1.3 million deaths worldwide (2,3). In the 1980s, World Health Organization (WHO) developed a case management strategy aiming to reduce deaths from pneumonia (4). While it suggests that in severe pneumonia, the cornerstones of management are antibiotic and supportive therapy, the