High flow nasal cannula for the treatment of respiratory disorders in premature newborns ≥34 weeks gestation

• P. A. Mazmanyan
• M. A. Darakchyan
• V. V. Keropyan

Abstract

Background and aim. Binasal cannula that deliver to patient humidified heated high gas flows becoming recently a popular form of respiratory support for infants and young children. Despite the absence of sufficient evidence of efficacy and safety from randomized trials, the method adopted by many neonatal units as a possible alternative to existing methods of non-invasive respiratory therapy.

Aim of the study was to determine the feasibility of usage high flow nasal cannula (HFNC) in population of the near term infants with respiratory disorders and to compare outcomes to a historical control group of who received head box oxygen or low flow nasal cannula.

Methods. We performed a matched case-control study with historical control group received treatment in the same unit for respiratory distress. High flow system at flow rate 10 l/min was used as a first line respiratory treatment for a 27 premature infants ≥34 weeks gestation, with respiratory distress. Criteria for treatment failure and indications for escalation of respiratory support was SpO2 <90% and FiO2 >0,6 or frequent apnoea.

Results. The median birth weight, gestational age and Downes score were similar in both groups. Duration of need of oxygen was significantly lower in HHFNC group (p<0,001). Treatment failure rate was lower in the HHFNC group (p=0,05). The was no significant difference in deaths, pneumothorax rate and nasal trauma between the groups.

Keywords:late pretem newborns, near term newborns, respiratory distress, continuous positive airway pressure, high flow nasal cannula