Abstract
Background: During humidified, high flow nasal cannula (HHFNC), heated and humidified gas is delivered at flow rates between 2-8 L/min via nasal cannulae. HHFNC has gained popularity as infants are perceived to be more comfortable and easily handled compared to nasal continuous positive airway pressure (nCPAP). Recent randomised trials, however, have not demonstrated superiority of HHFNC .
Aims and Objectives: To determine whether HHFNC use had changed between 2012 and 2015 and identify if and why practitioners preferred HHFNC or nCPAP.
Methods: An electronic web-base survey was carried out in 2015 and the results compared to our 2012 survey. All neonatal units in the UK were surveyed regarding indications for HHFNC and the flow rates and prong size used. They were also asked about the size and speed of flow rate reduction during weaning from HHFNC and their reasons for preferring HHFNC or CPAP
Results: In both 2015 and 2012, responses were received from 100% of units. HHFNC was used in 56% of units in 2012 and 87% in 2015 (p<0.001). In 2015 versus 2012, HHFNC was used more as primary support mode support post extubation (62% versus 42%, p=0.001). There was no consensus regarding weaning strategies from HHFNC; 36% of units had no guideline for HHFNC use. The majority of practitioners preferred HHFNC, their reasons included perceived better access to the infant, quicker achievement of full enteral feeding and less nasal trauma.
Conclusions: Use of HHFNC has significantly increased in UK neonatal units. The popularity of HHFNC and lack of consensus on weaning strategies highlights research is urgently needed to optimise weaning from HHFNC.
- Copyright ©the authors 2016
