Patient comfort during treatment with heated humidified high flow nasal cannulae versus nasal continuous positive airway pressure: a randomised cross-over trial.
OBJECTIVE
To compare patient comfort in preterm infants treated with heated humidified high flow nasal cannulae (HHHFNC) versus nasal continuous positive airway pressure (NCPAP).


METHODS
Randomised cross-over trial (2×24 h).


METHODS
Single tertiary neonatal unit.


METHODS
20 infants less than 34 weeks postmenstrual age treated with NCPAP due to mild respiratory illness.


METHODS
After parental consent, infants were randomised to 24 h of treatment with NCPAP or HHHFNC followed by 24 h of the alternate therapy.


METHODS
Primary outcome was patient comfort assessed by the EDIN (neonatal pain and discomfort) scale. Secondary outcomes were respiratory parameters (respiratory rate, FiO2, SpO2, TcPCO2), ambient noise, salivary cortisol and parental assessments of their child.


RESULTS
We found no differences between HHHFNC and NCPAP in mean cumulative EDIN score (10.7 vs 11.1, p=0.25) or ambient noise (70 vs 74 dBa, p=0.18). Parents assessed HHHFNC treatment as significantly better in the three domains, 1) child satisfied, 2) parental contact and interaction and 3) possibility to take part in care. Mean respiratory rate over 24 h was lower during HHHFNC than CPAP (41 vs 46, p=0.001). Other respiratory parameters were similar.


CONCLUSIONS
Using EDIN scale, we found no difference in patient comfort with HHHFNC versus NCPAP. However, parents preferred HHHFNC, and during HHHFNC respiratory rate was lower than during NCPAP.
NCT01526226.
Department of Paediatrics, University Hospital of North Norway, , Tromsø, Norway.
Claus
C
Klingenberg
Marit
M
Pettersen
Elin A
EA
Hansen
Linn J
LJ
Gustavsen
Ingvild A
IA
Dahl
Arild
A
Leknessund
Per I
PI
Kaaresen
Marianne
M
Nordhov
D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D009622:Noise; D063087:Noninvasive Ventilation / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D010290:Parents; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D006854:Hydrocortisone
Intensive Care; Neonatology; Patient perspective; Respiratory