title: High-flow nasal cannula oxygen and nasal continuous positive airway pressure and full oral feeding in infants with bronchopulmonary dysplasia.
abstract: OBJECTIVE
  To determine whether the time to achieve full oral feeding differed between infants with bronchopulmonary dysplasia (BPD) supported by nasal continuous positive airway pressure (nCPAP) compared with those supported by nCPAP and subsequently transferred to heated, humidified, high-flow nasal cannula oxygen (HHFNC).
  
  
  METHODS
  Two-cohort comparison.
  
  
  METHODS
  Tertiary neonatal unit.
  
  
  METHODS
  -72 infants, median gestational age 27 (range 24-32) weeks in the nCPAP group, and 44 infants, median gestational age 27 (range 24-31) weeks in the nCPAP/HHFNC group.
  
  
  METHODS
  Between 2011 and 2013, infants post extubation were supported by nCPAP and from 2013 infants were supported by nCPAP and then HHFNC.
  
  
  METHODS
  The postnatal age at which oral feeds were first trialled and full oral feeds established. The length of respiratory support as either nCPAP or nCPAP/HHFNC and the total length of respiratory support and hospital stay were also determined. Subanalysis was undertaken of infants requiring respiratory support beyond 34 weeks postmenstrual age (PMA).
  
  
  RESULTS
  The postnatal age at trial of first oral feeds was earlier in the nCPAP/HHFNC group (p=0.012), but infants were a shorter time on nCPAP compared with nCPAP/HHFNC (p=0.003). On subgroup analysis, the age to achieve full oral feeds was earlier in the nCPAP/HHFNC group (p<0.001).
  
  
  CONCLUSIONS
  In infants with BPD who required respiratory support beyond 34 weeks PMA, use of nCPAP then HHFNC was associated with earlier establishment of full oral feeds. Consideration should be given to assessing stable BPD infants with regard to oral feeding while on CPAP.
authors.affiliation: Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK Neonatal Intensive Care Centre, King's College Hospital, London, UK.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Neonatal Intensive Care Centre, King's College Hospital, London, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Hunt
authors.affiliation: Neonatal Intensive Care Centre, King's College Hospital, London, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Douthwaite
authors.affiliation: Neonatal Intensive Care Centre, King's College Hospital, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Athanasiou
authors.affiliation: Neonatal Intensive Care Centre, King's College Hospital, London, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Hickey
authors.affiliation: Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK NIHR Biomedical Centre at Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Greenough
mesh_terms: D001903:Bottle Feeding; D001997:Bronchopulmonary Dysplasia / Q000628:therapy*; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005865:Gestational Age; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007224:Infant Care; D007231:Infant, Newborn; D007234:Infant, Premature
keywords: Continuous positive airway pressure; Enteral feeding; Humidified, high flow nasal cannula