Neonatal Med.  2013 Nov;20(4):422-427. 10.5385/nm.2013.20.4.422.

A Comparison of Humidified High Flow Nasal Cannula with Bubble CPAP in Very Low Birth Weight Infants

• Gwon M
• Lee JJ
• Kim SB
• Park MS
• Lee JH

• KMID: 1876427
• DOI: http://doi.org/10.5385/nm.2013.20.4.422

Abstract

PURPOSE
To compare the effect of humidified high flow nasal cannula (HHFNC) with that of nasal continuous positive airway pressure (NCPAP) as the mode of extubation in very low birth weight infants (VLBWI).
METHODS
Medical records were retrospectively reviewed for 219 VLBWI who were admitted to the neonatal intensive care unit of Ajou University Hospital from January 2009 through December 2012; 87 were supported by noninvasive ventilation (NIV) after extubation (HHFNC n=47, NCPAP n=40). Extubation failure was defined as the need for reintubation within 1 week of extubation.
RESULTS
(1) There were no significant differences between the groups in demographic data such as gestational age, birth weight, and age at extubation. (2) There were no significant differences in fraction of inspired oxygen (FiO2) (HHFNC 0.23+/-0.03 vs. NCPAP 0.23+/-0.03, P-value .937) and peak inspiratory pressure (HHFNC 11+/-6.6 cmH2O vs. NCPAP 10.3+/-3.4 cmH2O, P-value .559) before extubation. (3) The rate of extubation failure and FiO2 values after extubation were similar in the 2 groups (extubation failure, HHFNC 5/47 vs. NCPAP 5/40, P-value 1.000; FiO2, HHFNC 0.24+/-0.05 vs. NCPAP 0.25+/-0.04, P-value .399). (4) Among patients who received NIV after extubation once but did not receive further intubation, the duration of NIV or duration of oxygen supply were not significantly different between the groups (NIV, HHFNC 12.4+/-9.1 days vs. NCPAP 8.7+/-12.3 days, P-value .159, oxygen supply, HHFNC 49.0+/-40.3 days vs. NCPAP 50.9+/-41.3 days, P-value .844) or bronchopulmonary dysplasia rate (HHFNC 24.3% vs. NCPAP 34.4%, P-value .430).
CONCLUSION
HHFNC is as effective as NCPAP for weaning VLBWIs from invasive mechanical ventilation.

Keyword

Noninvasive ventilation; Bronchopulmonary dysplasia; Preterm infants; Endotracheal extubation

MeSH Terms

Airway Extubation
Birth Weight
Bronchopulmonary Dysplasia
Catheters*
Continuous Positive Airway Pressure
Gestational Age
Humans
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Intensive Care, Neonatal
Intubation
Medical Records
Noninvasive Ventilation
Oxygen
Respiration, Artificial
Retrospective Studies
Weaning
Oxygen