Effect of randomization of nasal high flow rate in preterm infants

Journal article


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
AuthorsHough, Judith Leigh, Shearman, Andrew D., Jardine, Luke, Caldararo, Deborah and Schibler, Andreas
Abstract

Objective
To assess the effect of nasal high flow (NHF) cannula on end‐expiratory level (EEL), continuous distending pressure (CDP) and regional ventilation distribution in preterm infants.
Design
A prospective observational clinical study with randomly applied NHF rates.
Patients and Setting
Preterm infants requiring continuous positive airway pressure (CPAP) respiratory support in a Neonatal Intensive Care Unit.
Interventions
Infants were measured on randomly applied flow rates at 2, 4, and 6 L/min of NHF and compared with bubble CPAP.
Measurements and Results
Regional ventilation distribution and EEL were measured using electrical impedance tomography (EIT) and respiratory inductance plethysmography (RIP) in 24 preterm infants (31.19 ± 1.17 weeks corrected age). Changes in CDP were measured from the esophagus via the nasogastric tube. Physiological variables were also recorded. There were no differences in ventilation distribution, EEL or CDP between CPAP and NHF (P > .05). However, the physiological variables of FiO2 (P = .01) and SpO2/FiO2 (P < .01) were improved on CPAP compared with NHF.
Conclusion
NHF applied in random order with flow rates between 2 to 6 L/min was equally as good as CPAP in maintaining EEL and ventilation distribution in stable preterm infants. Overall oxygenation was better on CPAP compared to NHF.

KeywordsNeonatal Pulmonary Medicine; Respiratory Technology; Oxygenation and Therapy; CPAP; electrical impedance tomography; high flow nasal cannula; respiratory inductance plethysmography; ventilation distribution
Year2019
JournalPediatric Pulmonology
Journal citation54 (9), pp. 1410 - 1416
PublisherWiley Periodicals, Inc
ISSN8755-6863
Digital Object Identifier (DOI)https://doi.org/10.1002/ppul.24418
Scopus EID2-s2.0-85071028058
Open accessOpen access
Page range1410 - 1416
Research GroupSchool of Allied Health
Author's accepted manuscript
Place of publicationUnited States of America
EditorsT. Murphy
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