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

Gwon,  Myounghoon; Lee,  Jeong Ju; Kim,  Sang Bum; Park,  Moon Sung; Lee,  Jang Hoon

doi:2013.20.4.422

Neonatal Med > Volume 20(4); 2013 > Article

Original Article

Neonatal Medicine 2013;20(4):422-427.
DOI: https://doi.org/10.5385/nm.2013.20.4.422 Published online January 15, 2014.

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

Myounghoon Gwon, Jeong Ju Lee, Sang Bum Kim, Moon Sung Park, Jang Hoon Lee

Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea. neopedlee@gmail.com

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 (FiO2) (HHFNC 0.23+/-0.03 vs. NCPAP 0.23+/-0.03, P-value .937) and peak inspiratory pressure (HHFNC 11+/-6.6 cmH2O vs. NCPAP 10.3+/-3.4 cmH2O, P-value .559) before extubation. (3) The rate of extubation failure and FiO2 values after extubation were similar in the 2 groups (extubation failure, HHFNC 5/47 vs. NCPAP 5/40, P-value 1.000; FiO2, 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%, P-value .430).
CONCLUSION
HHFNC is as effective as NCPAP for weaning VLBWIs from invasive mechanical ventilation.

Key Words: Noninvasive ventilation; Bronchopulmonary dysplasia; Preterm infants; Endotracheal extubation