The evidence for high flow nasal cannula devices in infants.
High flow nasal cannula (HFNC) devices deliver an adjustable mixture of heated and humidified oxygen and air at a variable flow rate. Over recent years HFNC devices have become a frequently used method of non-invasive respiratory support in infants and preterm neonates that is generally popular amongst clinicians and nursing staff due to ease of use and being well tolerated by patients. Despite this rapid adoption relatively little is known about the exact mechanisms of action of HFNC however and only recently have data from randomised controlled trials started to become available. We describe the features of a modern HFNC device and discuss current knowledge about the mechanisms of action and results of clinical studies in preterm neonates and infants with bronchiolitis. We also highlight future areas of research that are likely to increase our understanding, inform best clinical practice and strengthen the evidence base for the use of HFNC.
Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, United Kingdom, NE1 4LP. Electronic address: iram.haq@nuth.nhs.uk.
Iram
I
Haq
Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, United Kingdom, NE1 4LP; Newcastle Neonatal Service, Ward 35, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom, NE1 4LP. Electronic address: sgopakalaje@yahoo.co.in.
Saikiran
S
Gopalakaje
Newcastle Neonatal Service, Ward 35, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom, NE1 4LP. Electronic address: alan.fenton@ncl.ac.uk.
Alan C
AC
Fenton
Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, United Kingdom, NE1 4LP. Electronic address: michael.mckean@nuth.nhs.uk.
Michael C
MC
McKean
Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, United Kingdom, NE1 4LP. Electronic address: christopher.o'brien@nuth.nhs.uk.
Christopher
C
J O'Brien
Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, United Kingdom, NE1 4LP; Institute of Cellular Medicine, Newcastle University. Electronic address: malcolm.brodlie@ncl.ac.uk.
Malcolm
M
Brodlie
D001988:Bronchiolitis / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D063087:Noninvasive Ventilation / Q000295:instrumentation*; D009666:Nose
Bronchiolitis; Continuous positive airway pressure; High flow nasal cannula; Infant; Neonate; Non-invasive ventilation; Respiratory distress syndrome