Changes in the use of humidified high flow nasal cannula oxygen

Shetty, Sandeep; Sundaresan, Adesh; Hunt, Katie; Desai, Parth Rakesh; Greenough, Anne

doi:10.1136/archdischild-2016-310497

Cited by 33 publications

(28 citation statements)

References 2 publications

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“…High-flow nasal cannula (HFNC) therapy is increasingly used in preterm infants; perceived benefits include ease of use, increased comfort and bonding 1. Systematic reviews have concluded that HFNC has similar efficacy to other non-invasive respiratory support in preterm infants >28 weeks gestation 2 3.…”

Section: Introductionmentioning

confidence: 99%

Physiological effects of high-flow nasal cannula therapy in preterm infants

Liew

Fenton

Harigopal

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectiveHigh-flow nasal cannula (HFNC) therapy is increasingly used in preterm infants despite a paucity of physiological studies. We aimed to investigate the effects of HFNC on respiratory physiology.Study designA prospective randomised crossover study was performed enrolling clinically stable preterm infants receiving either HFNC or nasal continuous positive airway pressure (nCPAP). Infants in three current weight groups were studied: <1000 g, 1000–1500 g and >1500 g. Infants were randomised to either first receive HFNC flows 8–2 L/min and then nCPAP 6 cm H2O or nCPAP first and then HFNC flows 8–2 L/min. Nasopharyngeal end-expiratory airway pressure (pEEP), tidal volume, dead space washout by nasopharyngeal end-expiratory CO2 (pEECO2), oxygen saturation and vital signs were measured.ResultsA total of 44 preterm infants, birth weights 500–1900 g, were studied. Increasing flows from 2 to 8 L/min significantly increased pEEP (mean 2.3–6.1 cm H2O) and reduced pEECO2 (mean 2.3%–0.9%). Tidal volume and transcutaneous CO2 were unchanged. Significant differences were seen between pEEP generated in open and closed mouth states across all HFNC flows (difference 0.6–2.3 cm H2O). Infants weighing <1000 g received higher pEEP at the same HFNC flow than infants weighing >1000 g. Variability of pEEP generated at HFNC flows of 6–8 L/min was greater than nCPAP (2.4–13.5 vs 3.5–9.9 cm H2O).ConclusionsHFNC therapy produces clinically significant pEEP with large variability at higher flow rates. Highest pressures were observed in infants weighing <1000 g. Flow, weight and mouth position are all important determinants of pressures generated. Reductions in pEECO2 support HFNC’s role in dead space washout.

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Section: Introductionmentioning

confidence: 99%

Physiological effects of high-flow nasal cannula therapy in preterm infants

Liew

Fenton

Harigopal

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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“…Heated humidified high flow nasal cannula (HFNC) is considered a new alternative for nCPAP and is increasingly used over the last few years in neonatal intensive care 5 6. Recent studies have suggested that HFNC is as effective as nCPAP in providing respiratory support in patients with respiratory distress syndrome or patients extubated from invasive mechanical ventilation 7–9.…”

Section: Introductionmentioning

confidence: 99%

Electrical activity of the diaphragm during nCPAP and high flow nasal cannula

Waal

Hutten

Kraaijenga

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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“…The use of humidified high‐flow nasal cannulae (HHFNC) as an alternative mode of noninvasive ventilation (NIV) in neonates has become widespread. A survey of UK neonatal units showed the proportion using HHFNC had increased from 56% in 2012 to 87% in 2015 . A recently reported Cochrane Review comparing the use of HHFNC against other NIV modes of ventilation immediately after birth or following extubation showed no significant difference in the rates of bronchopulmonary dysplasia (BPD) or death and no significant difference in the rates of treatment failure/reintubation.…”

Section: Success Versus Failure On Hhfnc Postextubation [For Continuomentioning

confidence: 69%