Premium
Optiflow vs Vapotherm as extended weaning mode from nasal continuous positive airway pressure in preterm infants ≤ 28 weeks gestational age
Author(s) -
FernandezAlvarez J. Ramon,
Mahoney Liam,
Gandhi Rashmi,
Rabe Heike
Publication year - 2020
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.24936
Subject(s) - medicine , continuous positive airway pressure , gestational age , necrotizing enterocolitis , bronchopulmonary dysplasia , nasal cannula , retinopathy of prematurity , mechanical ventilation , intraventricular hemorrhage , weaning , antenatal steroid , anesthesia , interquartile range , birth weight , cannula , pediatrics , surgery , pregnancy , biology , obstructive sleep apnea , genetics
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 χ 2 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.