Humidified high flow nasal cannula (HFFNC) and continuous positive airways pressure (CPAP) in infants with evolving bronchopulmonary dysplasia (BPD)

Abstract

Background: HHFNC is frequently used as an alternative to, or weaning from CPAP.

Aims and Objectives: To determine in infants with evolving BPD, whether HHFNC compared to CPAP reduced the work of breathing (WOB) and thoraco-abdominal asynchrony (TAA) and improved oxygen saturation (SaO₂).

Methods: Infants who remained CPAP dependent at two weeks of age were assessed. They were randomized on the first day to CPAP or HHFNC each for two hours and on the second day the order in which the modes were studied was reversed. The work of breathing was measured using a dual pressure transducer tipped catheter (Gaeltec, Dunvegan, Scotland, UK) and the degree of asynchrony by respiratory inductance plethysmography. WOB, TAA and SaO₂ were assessed during the last five minutes at the end of each two hour period. The results from the study periods were meaned.

Results: Fifteen infants with a median gestational age of 27.6 (range 24.6-31.9) weeks and median birth weight of 880 (range 512-1500) grams were studied at a median postconceptional age of 30.9 (range 28.7-39.1) weeks. There were no significant differences in the results of the physiological measurements (data expressed as median, range).

Conclusion: In infants with evolving BPD, HHFNC compared to CPAP offered no significant advantage with regard to WOB, TAA or SaO₂.