High-flow nasal cannulae are associated with increased diaphragm activation compared with nasal continuous positive airway pressure in preterm infants

Acta Paediatrica
Nehad NasefEugene Ng

Abstract

High-flow nasal cannulae (HFNC) are increasingly used for respiratory management of preterm infants. However, their ability to provide support compared to nasal continuous positive airway pressure (CPAP) has been questioned. We compared the effect of HFNC versus nasal CPAP on diaphragm electrical activity (EAdi) in preterm infants. Preterm infants ≤1500 g were randomised in a crossover design to receive 2 hours of either Infant Flow(®) CPAP (IF-CPAP) at 5-6 cmH2 O or HFNC with the flow rate adjusted to achieve an equivalent pharyngeal pressure. A feeding catheter with miniaturised sensors was inserted for continuous EAdi measurement. The study comprised ten infants. Physiologic parameters and oxygen requirements were not different between the two modes. However, seven infants demonstrated a higher EAdi peak and six showed a higher EAdi tonic on HFNC, even though the mean group data showed no difference between HFNC and IF-CPAP. Neural inspiratory time was significantly longer with HFNC than IF-CPAP (0.55 ± 0.11 versus 0.48 ± 0.06 seconds, p = 0.018). In this cohort of preterm infants, the majority exhibited greater diaphragm activation, as assessed by neural breathing patterns, when supported with HFNC than IF-CPAP, suggesting ...Continue Reading

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Citations

Jan 16, 2016·Archives of Disease in Childhood. Fetal and Neonatal Edition·Sandeep ShettyAnne Greenough
Nov 14, 2016·Clinics in Perinatology·Kimberly S FirestoneHoward Stein
Sep 14, 2017·Pediatric Research·Sudarshan R Jadcherla, Vineet Bhandari
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Feb 24, 2016·The Cochrane Database of Systematic Reviews·Dominic WilkinsonBrett J Manley
Mar 5, 2021·Journal of Applied Physiology·Charles AlainJean-Paul Praud

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