title: A randomized controlled trial to compare heated humidified high-flow nasal cannulae with nasal continuous positive airway pressure postextubation in premature infants.
abstract: OBJECTIVE
  To determine whether postextubation respiratory support via heated, humidified, high-flow nasal cannulae (HHHFNC) results in a greater proportion of infants younger than 32 weeks' gestation being successfully extubated after a period of endotracheal positive pressure ventilation compared with conventional nasal continuous positive airway pressure (NCPAP).
  
  
  METHODS
  We randomly assigned preterm ventilated infants to Vapotherm HHHFNC or NCPAP after extubation. The primary outcome, extubation failure, was defined by prespecified failure criteria in the 7 days after extubation.
  
  
  RESULTS
  A total of 132 ventilated infants younger than 32 weeks' gestation were randomized to receive either HHHFNC (n = 67) or NCPAP (n = 65). Extubation failure occurred in 15 (22%) of the HHHFNC group compared with 22 (34%) of the NCPAP group. There was no difference in the number of infants reintubated in the first week. Treatment with HHHFNC reduced the nasal trauma score 3.1 (SD 7.2) versus NCPAP 11.8 (SD 10.7), P < .001.
  
  
  CONCLUSIONS
  HHHFNC and NCPAP produced similar rates of extubation failure.
authors.affiliation: Department of Pediatrics, Mercy Hospital for Women, Melbourne, Victoria, Australia. ccollins@mercy.com.au
authors.forename: Clare L
authors.initials: CL
authors.lastname: Collins
authors.forename: James R
authors.initials: JR
authors.lastname: Holberton
authors.forename: Charles
authors.initials: C
authors.lastname: Barfield
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
mesh_terms: D060666:Airway Extubation / Q000379:methods*; D057785:Catheters; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006361:Heating; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome