Abstract
Background: High flow (HF) therapy has been increasingly used over last decade in the treatment of neonatal respiratory distress 1-5.
To date, there are no data available supporting the choice of high flow as primary respiratory support in extremely preterm babies. There is no evidence available on the weaning of high flow 13.
METHODS: We submitted an online questionnaire to the tertiary NICUs in UK and Northern Ireland.
The online survey and reminders were sent over 2 months period (November 2015 to January 2016).
RESULTS: Out of the 57 units asked to take part, a total of 43 returned the questionnaire (75%).
High Flow is used in 14 (33%) units, while 25 (58%) use CPAP. Non-invasive ventilation is started in the delivery suite in 28 units (65%), however only 2% use HF for transport to NICU. Minimally invasive surfactant therapy is administered in 7 units (16%).
There is a high variability in the starting flow rate for high HF on preterm babies less than 28 weeks of gestational age. Most common starting flow rate for both term and preterm babies is 6 L/min. HF is not commonly used for weaning CPAP.
There is a large variation in the rate of weaning of HF, though 63% of the units are used to decrease it by 1 L/min every 24 hours.
63% of the units would consider to use HF in preterm babies less than 27 weeks GA, and 44% would start it in 25-26 weeks GA upon delivery.
CONCLUSION: There is an emerging trend towards use of HF as a first line treatment of RDS in extreme preterm babies above 25 weeks of GA. The survey shows a high degree of variation in the use of non-invasive ventilation among tertiary units in UK . There is an urgent need for RCT studies on the use and weaning of high flow.
- Copyright ©the authors 2016
