Heated High Flow Oxygen Use in Infants With Bronchiolitis and Hypoxia

Inclusion Criteria: 1. Are previously healthy infants ages 3 months to 18 months of age 2. Have O2 saturations of \< 92% on room air while awake 3. Have a clinical diagnosis of bronchiolitis 4. Have a CSS score showing moderate distress \>4 5. Have a planned admission to the hospital for either inpatient or observation status 6. Have parental consent to enroll in study Exclusion Criteria: 1. Have significant apnea or bradycardia events reported by parent or witnessed in Emergency Department 2. Have prior airway disease diagnosis other than URI within the previous two months 3. Were previously intubated; previously having had airway bronchoscopy or surgery 4. They are ex-preemies, i.e. had an estimated gestational age of \<37 weeks at time of birth 5. Have a diagnosis of lobar consolidation or round pneumonia by Chest x-ray 6. Have pleural disease by chest x-ray 7. Have history of cardiac disease, renal disease, hematologic disease such as sickle cell disease or leukemia, congenital hemoglobinopathies or Congenital Adrenal Hyperplasia 8. Have undergone prior radiation or chemotherapy 9. Have functional or anatomical bowel obstruction as demonstrated by persistent vomiting or tensely distended abdomen 10. Have history of Choanal atresia or cleft palate 11. Have history of neuromuscular disorder, e.g., Spinal muscular atrophy, muscular dystrophies, cerebral palsy or hypotonia 12. Have impending respiratory failure as demonstrated by blood gas with pCO2 of greater than 60 or apnea spells lasting greater than 30 seconds