High Flow Nasal Cannula versus Nasal CPAP in Preterm Infants

Yoon, Seong ho; Kwon, Young hee; Park, Hyun kyung; Kim, Chang ryul; Seol, In jun; Lee, Hyun Ju

Abstract

PURPOSE
The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants.
METHODS
A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth.
RESULTS
Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2+/-16.7 vs. 24.7+/-10.2, P=0.05) and regain birth weight (20.9+/-16.9 vs. 17.2+/-4.3, P=0.04) decreased in the HHFNC group.
CONCLUSION
HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.