Strategies for the withdrawal of humidified high flow nasal cannulae (HHFNC) in preterm infants

Journal article


Farley, Raymond C., Hough, Judith L. and Jardine, Luke A.. (2015). Strategies for the withdrawal of humidified high flow nasal cannulae (HHFNC) in preterm infants. Cochrane Database of Systematic Reviews. 6, p. Article CD011079. https://doi.org/10.1002/14651858.CD011079.pub2
AuthorsFarley, Raymond C., Hough, Judith L. and Jardine, Luke A.
Abstract

Background
Humidified high flow nasal cannula (HHFNC) delivers humidified gas at increased flow rates via binasal prongs and is becoming widely accepted as a method of non‐invasive respiratory support for preterm infants. While indications for the use of (HHFNC) and its associated risks and benefits are being investigated, the best strategy for the discontinuation of HHFNC remains unknown. At what point an infant is considered stable enough to attempt to start withdrawing their HHFNC is not known. The criteria for a failed attempt at HHFNC discontinuation is also unclear.

Objectives
To determine the risks and benefits of different strategies used for the discontinuation of HHFNC in preterm infants.

Search methods
We searched the Cochrane Neonatal Review Group Specialized Register, PubMed (1966 to March 2015), CINAHL (1982 to March 2015), EMBASE (1980 to March 2015), and the Cochrane Central Register of Controlled Trials (CENTRAL). Also, we checked previous reviews, including cross references. We searched for following web sites for ongoing trials: ClinicalTrials.gov and controlled‐trials.com.

Selection criteria
We included randomised controlled trials (RCTs) and quasi‐RCTs in which either individual newborn infants or clusters of infants (such as separate neonatal units) were randomised to different HHFNC withdrawal strategies (from the first time they come off HHFNC and any subsequent weaning, or withdrawal attempt, or both).

Data collection and analysis
We used standard methods of Cochrane and the Cochrane Neonatal Review Group.

Main results
We identified no eligible studies examining the best strategy to wean or withdraw HHFNC once started as respiratory support in preterm infants

Authors' conclusions
There is currently no evidence available to suggest the best strategy for weaning and withdrawing HHFNC as a respiratory support in preterm infants. Research is required into the best strategy for withdrawal of HHFNC and to which subgroups this applies. Clear criteria for the definition of stability prior to attempting to withdraw HHFNC needs to be established. Furthermore, clear definitions are needed as to what constitutes failure of HHFNC.

Keywordshumans; infant; newborn; premature; continuous positive airway pressure; device removal; humidifiers; noninvasive ventilation; ventilator weaning
Year2015
JournalCochrane Database of Systematic Reviews
Journal citation6, p. Article CD011079
PublisherJohn Wiley & Sons
ISSN1469-493X
Digital Object Identifier (DOI)https://doi.org/10.1002/14651858.CD011079.pub2
PubMed ID26041053
Scopus EID2-s2.0-84940857948
Open accessOpen access
Page range1-9
Research GroupSchool of Allied Health
Publisher's version
License
All rights reserved
File Access Level
Open
Output statusPublished
Publication dates
Online04 Jun 2015
Permalink -

https://acuresearchbank.acu.edu.au/item/858zx/strategies-for-the-withdrawal-of-humidified-high-flow-nasal-cannulae-hhfnc-in-preterm-infants

Download files


Publisher's version
Farley_2015_Strategies_for_the_discontinuation_of_humidified.pdf
License: All rights reserved
File access level: Open

  • 125
    total views
  • 89
    total downloads
  • 0
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

High flow nasal cannula for respiratory support in term infants (Review)
Dopper, Alex, Steele, Michael, Bogossian, Fiona and Hough, Judith. (2023). High flow nasal cannula for respiratory support in term infants (Review). Cochrane Database of Systematic Reviews. 2023(8), p. Article CD011010. https://doi.org/10.1002/14651858.CD011010.pub2
Physiotherapy practices when treating patients with COVID-19 during a pandemic : A survey study
Trojman, Anthony, Hough, Judith, Hides, Julie, Gustafsson, Louise, Flores, Orlando and Paratz, Jennifer. (2023). Physiotherapy practices when treating patients with COVID-19 during a pandemic : A survey study. Heart and Lung. 57, pp. 152-160. https://doi.org/10.1016/j.hrtlng.2022.09.012
Measuring the effects of airway clearance in mechanically ventilated infants and children : A systematic review
McAlinden, Bronagh M., Hough, Judith L. and Kuys, Suzanne. (2022). Measuring the effects of airway clearance in mechanically ventilated infants and children : A systematic review. Physiotherapy. 117, pp. 47-62. https://doi.org/10.1016/j.physio.2022.08.010
Lung recruitment manoeuvres for reducing mortality and respiratory morbidity in mechanically ventilated neonates
Blazek, E. V., East, C. E., Jauncey-Cooke, J., Bogossian, F., Grant, C. A. and Hough, J.. (2021). Lung recruitment manoeuvres for reducing mortality and respiratory morbidity in mechanically ventilated neonates. Cochrane Database of Systematic Reviews. 3, pp. 1-42. https://doi.org/10.1002/14651858.CD009969.pub2.
A quality appraisal using the AGREE II instrument of endotracheal tube suction guidelines in neonatal intensive care units
Hough, Judith L., Barton, Jaimi and Jardine, Luke A.. (2021). A quality appraisal using the AGREE II instrument of endotracheal tube suction guidelines in neonatal intensive care units. Australian Critical Care. 34(6), pp. 524-529. https://doi.org/10.1016/j.aucc.2021.02.001
Chest physiotherapy improves regional lung volume in ventilated children.
McAlinden, B., Kuys, Suzanne Shanelle, Schibler, Andreas and Hough, Judith Leigh. (2020). Chest physiotherapy improves regional lung volume in ventilated children. Critical Care (UK). 24, pp. 1-4. https://doi.org/10.1186/s13054-020-03156-2
Nasal high flow in preterm infants : A dose-finding study
Hough, Judith L., Shearman, Andrew D., Jardine, Luke and Schibler, Andreas. (2019). Nasal high flow in preterm infants : A dose-finding study. Pediatric Pulmonology. 55(3), pp. 616-623. https://doi.org/10.1002/ppul.24617
Simulation-based education improves student self-efficacy in physiotherapy assessment and management of paediatric patients
Hough, Judith, Levan, Daniel Anthony, Steele, Michael, Kelly, Kristine and Dalton, Megan. (2019). Simulation-based education improves student self-efficacy in physiotherapy assessment and management of paediatric patients. BMC Medical Education. 19(1), pp. 1 - 11. https://doi.org/10.1186/s12909-019-1894-2
Chest wall mesenchymal hamartoma in an infant: Evaluation with electrical impedance tomography
Jardine, Luke, Chen, Julie and Hough, Judith Leigh. (2019). Chest wall mesenchymal hamartoma in an infant: Evaluation with electrical impedance tomography. Pediatric Pulmonology. 54(11), pp. E14 - E16. https://doi.org/10.1002/ppul.24483
Effect of randomization of nasal high flow rate in preterm infants
Hough, Judith Leigh, Shearman, Andrew D., Jardine, Luke, Caldararo, Deborah and Schibler, Andreas. (2019). Effect of randomization of nasal high flow rate in preterm infants. Pediatric Pulmonology. 54(9), pp. 1410 - 1416. https://doi.org/10.1002/ppul.24418
An evidence-based approach to influencing evidence-based practice in allied health
Wilkinson, Shelley, Hough, Judith Leigh and Hinchliffe, Fiona. (2016). An evidence-based approach to influencing evidence-based practice in allied health. Journal of Allied Health. 45(1), pp. 41-48.
Effect of time and body position on ventilation in premature infants
Hough, Judith Leigh, Trojman, Anthony Paul and Schibler, Andreas. (2016). Effect of time and body position on ventilation in premature infants. Pediatric Research. 80(4), pp. 499 - 504. https://doi.org/10.1038/pr.2016.116
Prevalence and impact of pelvic floor dysfunction in an adult cystic fibrosis population
Chambers, Rebecca, Lucht, Adam John, Reihill, Aisling and Hough, Judith Leigh. (2016). Prevalence and impact of pelvic floor dysfunction in an adult cystic fibrosis population. International Urogynecology Journal and Pelvic Floor Dysfunction. 28(4), pp. 591 - 604. https://doi.org/10.1007/s00192-016-3152-z
Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography
Hough, Judith Leigh, Shearman, Andrew, Liley, Helen, Grant, Caroline and Schibler, Andreas. (2014). Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography. Journal of Paediatrics and Child Health. 50(11), pp. 884 - 889. https://doi.org/10.1111/jpc.12661
High-flow nasal cannula therapy for respiratory support in children
Mayfield, Sara, Jauncey-Cooke, Jacqueline, Hough, Judith, Schibler, Andreas, Gibbons, Kristen and Bogossian, Fiona Elizabeth. (2014). High-flow nasal cannula therapy for respiratory support in children. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009850.pub2
Physiologic effect of high-flow nasal cannula in infants with bronchiolitis
Hough, Judith Leigh, Pham, Trang and Schibler, Andreas. (2014). Physiologic effect of high-flow nasal cannula in infants with bronchiolitis. Pediatric Critical Care Medicine. 15(5), pp. e214 - e219. https://doi.org/10.1097/PCC.0000000000000112
The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants
Montgomery, Karly, Low Choy, Nancy, Steele, Michael and Hough, Judith. (2014). The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants. Journal of Paediatrics and Child Health. 50(12), pp. 972 - 977. https://doi.org/10.1111/jpc.12689
Effect of body position on ventilation distribution in ventilated preterm infants
Hough, Judith, Johnston, Leanne, Brauer, Sandy, Woodgate, Paul and Schibler, Andreas. (2013). Effect of body position on ventilation distribution in ventilated preterm infants. Pediatric Critical Care Medicine. https://doi.org/10.1097/PCC.0b013e31826e708a
Effect of body position on ventilation distribution in ventilated preterm infants
Hough, Judith L., Johnston, Leanne, Brauer, Sandy, Woodgate, Paul and Schibler, Andreas. (2013). Effect of body position on ventilation distribution in ventilated preterm infants. Pediatric Critical Care Medicine. 14(2), pp. 171 - 177. https://doi.org/10.1097/PCC.0b013e31826e708a
Baseline evidence based practice use, knowledge, and attitudes of allied health professionals : A survey to inform staff training and organisational change
Wilkinson, Shelley, Hinchliffe, Fiona, Hough, Judith and Chang, Anne. (2012). Baseline evidence based practice use, knowledge, and attitudes of allied health professionals : A survey to inform staff training and organisational change. Journal of Allied Health. 41(4), pp. 177 - 184.
Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure
Hough, Judith L., Johnston, Leanne, Brauer, Sandy G., Woodgate, Paul G., Pham, Trang MT and Schibler, Andreas. (2012). Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure. Pediatric Critcal Care Medicine. 13(4), pp. 446 - 451. https://doi.org/10.1097/PCC.0b013e31822f18d9
Talipes equinovarus (clubfoot)
Hough, Judith Leigh, Bagley, Catherine and Koorts, Pieter J.. (2012). Talipes equinovarus (clubfoot). In In M. W. Davies, G. D. T. Inglis and L. A. Jardine & P. J. Koorts (Ed.). Antenatal consults : A guide for neonatologists and paediatricians pp. 281-284 Churchill Livingstone.
Lung recruitment manoeuvres for reducing respiratory morbidity in mechanically ventilated neonates
Jauncey-Cooke, J, Bogossian, F, Hough, J., Schibler, A, Davies, M W., Grant, C A., Gibbons, K and East, C E.. (2012). Lung recruitment manoeuvres for reducing respiratory morbidity in mechanically ventilated neonates. Cochrane Database of Systematic Reviews. Art.No.: CD009969 (Issue 7). https://doi.org/10.1002/14651858.CD009969
Humidified high flow nasal cannulae : Current practice in Australasian nurseries, a survey
Hough, Judith, Shearman, Andrew, Jardine, Luke and Davies, Mark. (2012). Humidified high flow nasal cannulae : Current practice in Australasian nurseries, a survey. Journal of Paediatrics and Child Health. 48(2), pp. 106 - 113. https://doi.org/10.1111/j.1440-1754.2011.02070.x
Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery
Schibler, Andreas, Pham, Trang, Dunster, Kimble, Foster, Kim, Barlow, A, Gibbons, Kristen and Hough, Judith. (2011). Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Medicine. 37(5), pp. 847 - 852. https://doi.org/10.1007/s00134-011-2177-5
Measurement of ventilation and cardiac related impedance changes with electrical impedance tomography
Grant, Caroline, Pham, Trang, Hough, Judith, Riedel, T, Stocker, C and Schibler, Andreas. (2011). Measurement of ventilation and cardiac related impedance changes with electrical impedance tomography. Critical Care. 15(1), pp. 1 - 9. https://doi.org/10.1186/cc9985