Premium
Effect of randomization of nasal high flow rate in preterm infants
Author(s) -
Hough Judith L.,
Shearman Andrew D.,
Jardine Luke,
Caldararo Deborah,
Schibler Andreas
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24418
Subject(s) - medicine , nasal cannula , continuous positive airway pressure , anesthesia , ventilation (architecture) , neonatal intensive care unit , plethysmograph , mechanical ventilation , respiratory rate , intensive care , mean airway pressure , cannula , heart rate , pediatrics , obstructive sleep apnea , surgery , blood pressure , intensive care medicine , mechanical engineering , engineering
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 FiO 2 ( P = .01) and SpO 2 /FiO 2 ( 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.