Nasal continuous positive airway pressure from high flow cannula versus Infant Flow for Preterm infants.
OBJECTIVE
To compare the feasibility of continuous positive airway pressure (CPAP) support generated by high flow nasal cannula with conventional CPAP for prevention of reintubation among preterm infants with a birth weight of <or=1,250 g.


METHODS
Preterm infants were randomized to CPAP generated via high flow cannula or the Infant Flow Nasal CPAP System (VIASYS, Conshohocken, PA, USA) at extubation. Primary outcome was incidence of reintubation within 7 days. Secondary outcomes included change in oxygen use and frequency of apnea and bradycardias postextubation.


RESULTS
Forty neonates were randomized. Twelve of 20 infants randomized to high flow cannula CPAP were reintubated compared to three of 20 using Infant Flow (P=0.003). The high flow cannula group had increased oxygen use and more apneas and bradycardias postextubation.


CONCLUSIONS
CPAP delivered by high flow nasal cannula failed to maintain extubation status among preterm infants <or=1,250 g as effectively as Infant Flow CPAP.
Campbell
D M
DM
Department of Paediatrics, Mt Sinai Hospital, University of Toronto, Toronto, ON, Canada. campbelld@smh.toronto.on.ca
Shah
P S
PS
Shah
V
V
Kelly
E N
EN
D001049:Apnea / Q000628:therapy*; D001724:Birth Weight; D002404:Catheterization; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D009864:Ontario; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D015300:Ventilator Weaning