High flow nasal cannula for continuous positive airway pressure weaning in preterm neonates: A single‐centre experience

Sasi, Arun; Malhotra, Atul

doi:10.1111/jpc.12693

Cited by 25 publications

(32 citation statements)

References 24 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings support a retrospective study conducted by Sasi and Malhotra [10], who compared respiratory outcomes in preterm infants with a GA of ≤32 weeks at 2 time points, i.e. before and after use of HHHFNC.…”

Section: Discussionsupporting

confidence: 78%

“…Regarding CPAP weaning, the optimal method of weaning infants from NCPAP remains obscure, with a wide variation in weaning practices among neonatologists [10,13,14,15,16]. A study by Todd et al [17] showed that weaning time when weaning directly from CPAP was shorter than that using low-flow nasal cannula during a cycling time-off period.…”

Section: Introductionmentioning

confidence: 99%

“…However, recent randomized controlled trials have shown that HHHFNC is either as effective or is noninferior to CPAP in the prevention of extubation failure [6,7,8]. HHHFNC has also been used as a primary respiratory support in apnea of prematurity, respiratory distress syndrome and as a weaning method from CPAP [9,10,11,12]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Heated Humidified High-Flow Nasal Cannula for Weaning from Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

Soonsawad

Tongsawang²,

Nuntnarumit³

2016

Neonatology

View full text Add to dashboard Cite

Background: Heated humidified high-flow nasal cannula (HHHFNC) therapy has been widely used in preterm infants. However, evidence to support its use as a continuous positive airway pressure (CPAP) weaning method is still controversial. Objectives: We aimed to compare time to wean directly off CPAP vs. weaning by using HHHFNC. Methods: Infants with a gestational age (GA) of <32 weeks who met the predefined criteria for weaning off CPAP, i.e. with a CPAP of ≤6 cm H₂O and a fraction of inspired oxygen (FiO₂) of ≤0.3 for at least 24 h, were randomly assigned to wean by using HHHFNC or wean directly from CPAP. In the HHHFNC group, flow rate was reduced by 1 liter/min every 24 h to 2-3 liters/min depending on body weight (i.e. < or ≥1,000 g), and then HHHFNC was discontinued. In the CPAP group, pressure was reduced by 1 cm H₂O every 24 h until stable on CPAP 4 cm H₂O and then discontinued. The primary outcome was the time it took to wean off the use of the CPAP or HHHFNC devices. Results: One-hundred and one infants were enrolled, 51 in the HHHFNC and 50 in the CPAP group. Both groups had similar demographics and respiratory conditions before enrollment. There was no difference in time to successfully wean between the 2 groups [median (IQR): 11 (4-21) days in the HHHFNC group vs. 11 (4-29) days in the CPAP group; p = 0.12]. There were no differences in morbidities or related complications. Infants in the HHHFNC group had significantly less nasal trauma (20 vs. 42%; p = 0.01). Conclusions: In our study, the time to wean off CPAP using HHHFNC was not different from when weaning directly from CPAP.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Heated Humidified High-Flow Nasal Cannula for Weaning from Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

Soonsawad

Tongsawang²,

Nuntnarumit³

2016

Neonatology

View full text Add to dashboard Cite

show abstract

“…3) Discharging infants with chronic lung disease on NC oxygen with variable flows or concentrations is an emerging trend, as well as a method of weaning from positive pressure or noninvasive ventilation. However, in studies comparing high-flow NC vs. nCPAP, no differences in outcomes related to length of stay or BPD are noted (2,21,27,31), yet feeding strategies or functional clinical outcomes have not been examined. Furthermore, safety to feed while on NC/nCPAP with variable flows remains a concern among providers.…”

Section: Discussionmentioning

confidence: 99%

“…IMPROVEMENT OF RESPIRATORY outcomes in premature infants through utilization of noninvasive respiratory support [nasal continuous positive airway pressure (nCPAP) or variableflow nasal cannula (NC)] has been reported (24, 30, 30a) and is considered as a first line of respiratory therapy, or as a step-down approach upon extubation (20,22,24,27). Due to relatively low expense, ease of administration, and ability to provide developmental support, these noninvasive respiratory support measures are promising and increasingly popular among low-resource nations, where the prevalence of premature birth or volume of high-risk infants is increasing.…”

mentioning

confidence: 99%

Effect of nasal noninvasive respiratory support methods on pharyngeal provocation-induced aerodigestive reflexes in infants

Jadcherla

Hasenstab

Sitaram

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

show abstract

Optiflow vs Vapotherm as extended weaning mode from nasal continuous positive airway pressure in preterm infants ≤ 28 weeks gestational age

Álvarez

Mahoney

Gandhi

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Introduction Current evidence supports nasal continuous positive airway pressure (NCPAP) weaning. Heated humidified high‐flow nasal cannula (HHFNC) reduces NCPAP time in infants less than 28 weeks gestational age (GA) without increasing morbidity. The aim of the study was to compare the two most frequently used HHFNC devices in weaning from NCPAP. Methodology We performed a retrospective matched‐pair case‐control study of infants less than or equal to 28 GA born in a single tertiary neonatal center managed with Optiflow or Vapotherm after being weaned from NCPAP. Patients were matched for antenatal steroid doses, delivery mode, birth plurality, GA, birthweight, gender, surfactant doses, length of mechanical ventilation, and length of NCPAP. Outcome measures were duration of HHFNC, low‐flow nasal cannula, nasal bridge lesions, pneumothorax, bronchopulmonary dysplasia, postnatal steroids, necrotizing enterocolitis, sepsis, intraventricular hemorrhage, retinopathy of prematurity, length of stay, discharge weight, and mortality. Results were displayed as median (interquartile range) or ratio (percentage). Statistical analysis was performed using Mann‐Whitney U and χ2 tests. Results 70 patients were recruited retrospectively. Thirty‐five infants were weaned from NCPAP to Optiflow and 35 infants to Vapotherm with gestational ages and birthweights of 27 GA (26‐27) and 1010 g (835‐1165) and 27 GA (26‐28) and 960 g (788‐1191), respectively. There was no statistically significant difference in any outcome measure. Infants managed with Vapotherm required a not statistically significant shorter length of time on HHFNC and low‐flow nasal cannula. Conclusions Optiflow and Vapotherm seem to be equally effective and safe for weaning from NCPAP. However, infants weaned to Vapotherm appear to spend less time on non‐invasive respiratory support.

show abstract

High flow nasal cannula for continuous positive airway pressure weaning in preterm neonates: A single‐centre experience

Abstract: Introduction of HFNC for weaning nasal CPAP seems to have a minimal effect on CLD rates. The effect of HFNC on long-term outcomes needs to be further evaluated.

Cited by 25 publications

References 24 publications

Heated Humidified High-Flow Nasal Cannula for Weaning from Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

Heated Humidified High-Flow Nasal Cannula for Weaning from Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

Effect of nasal noninvasive respiratory support methods on pharyngeal provocation-induced aerodigestive reflexes in infants

Optiflow vs Vapotherm as extended weaning mode from nasal continuous positive airway pressure in preterm infants ≤ 28 weeks gestational age

Contact Info

Product

Resources

About