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

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 (FiO 2 ) (HHFNC 0.23±0.03 vs. NCPAP 0.23±0.03, P-value .937) and peak inspiratory pressure (HHFNC 11±6.6 cmH 2 O vs. NCPAP 10.3±3.4 cmH 2 O, P-value .559) before extubation. (3) The rate of extubation failure and FiO 2 values after extubation were similar in the 2 groups (extubation failure, HHFNC 5/47 vs. NCPAP 5/40, P-value 1.000; FiO 2 , 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%,. Conclusion: HHFNC is as effective as NCPAP for weaning VLBWIs from invasive mechanical ventilation.

Pulmonary Outcomes of Early Extubation in Extremely Premature Infants (Gestational Age: 25–26 Weeks) with Synchronized Nasal Intermittent Positive-Pressure Ventilation

“…Although some studies from Korea investigated the therapeutic effect of NIPPV or CPAP in premature infants 21,22) , studies on extremely premature infants are limited. In this study, we aimed to investigate the pulmonary outcomes of early airway extubation (within the first 24 hours of life) with synchronized NIPPV in extremely premature infants born at 25-26 weeks' gestation.…”