Comparison of clinical efficacy of heated humidified high flow nasal cannula versus nasal continuous positive airway pressure in treatment of respiratory distress syndrome in very low birth weight infants
CHEN Jia, GAO Wei-Wei, XU Fang, DU Lan-Lan, ZHANG Tao, LING Xing, LI Wei-Tao
Department of Neonatology, Guangdong Provincial Women and Children's Hospital, Guangzhou 511400, China
Abstract：Objective To compare the differences of clinical efficacy between heated humidified high-flow nasal cannula (HHHFNC) ventilation and nasal continuous positive airway pressure (NCPAP) in the treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants. Methods A total of 66 VLBW infants who were admitted to the neonatal intensive care unit were diagnosed with RDS, and they were randomly assigned to HHHFNC group and NCPAP group after receiving treatment with porcine pulmonary surfactant and conventional treatment. The changes in clinical symptoms and the incidence of complications were observed in the two groups. Results The HHHFN group had significantly earlier first milk feeding and full enteral feeding, significantly shorter oxygen exposure time and invasive ventilation time, and significantly lower incidences of second intubation within 7 days, nasal injury, air leak, and abdominal distention, as compared with the NCPAP group. Conclusions Compared with NCPAP, HHHFNC causes slighter injury and has better tolerability, and it can be considered as the first choice of noninvasive ventilation in the treatment of RDS in VLBW infants.
CHEN Jia,GAO Wei-Wei,XU Fang et al. Comparison of clinical efficacy of heated humidified high flow nasal cannula versus nasal continuous positive airway pressure in treatment of respiratory distress syndrome in very low birth weight infants[J]. CJCP, 2015, 17(8): 847-851.
Jobe AH. What is RDS in 2012?[J]. Early Hum De, 2012, 88 Suppl 2: S42-S44.
[2]
Kamath BD, Macguire ER, McClure EM, et al. Neonatal mortality from respiratory distress syndrome: lessons for low-resource countries[J]. Pediatrics, 2011, 127(6): 1139-1146.
[3]
Verder H, Bohlin K, Kamper J, et al. Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia[J]. Acta Paediatr, 2009, 98(9): 1400-1408.
Walsh BK, Brooks TM, Grenier BM. Oxygen therapy in the neonatal care environment[J]. Respir Care, 2009, 54(9): 1193-1202.
[6]
Manley BJ, Owen L, Doyle LW, et al. High flow nasal cannulae and nasal continuous positive airway pressure use in non-tertiary special care nurseries in Australia and New Zealand[J]. J Paediatr Child Health, 2012, 48(1): 16-21.
[7]
Nath P, Ponnusamy V, Willis K, et al. Current practices of high and low flow oxygen therapy and humidification in UK neonatal units[J]. Pediatr Int, 2010, 52(6): 893-894.
[8]
Holleman-Duray D, Kaupie D, Weiss MG. Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol[J]. J Perinatol, 2007, 27(12): 776-781.
Ramani M, Ambalavanan N. Feeding practices and necrotizing enterocolitis[J]. Clin Perinatol, 2013, 40(1): 1-10.
[12]
Jobe AH, Bancalari E. Bronchopulmonary dysplasia[J]. Am J Respir Crit Care Med, 2001, 163(7): 1723-1729.
[13]
Dani C, Corsini I, Bertini G, et al. The INSURE method in preterm infants of less than 30 weeks'gestation[J]. J Matern Fetal Neonatal Med, 2010, 23(9): 1024-1029.
Jatana KR, Oplatek A, Stein M, et al. Effects of nasal continuous positive airway pressure and cannula use in the neonatal intensive care unit setting[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(3): 287-291.
[17]
Hough JL, Shearman AD, Jardine LA, et al. Humidified high flow nasal cannulae: current practice in Australasian nurseries, a survey[J]. J Paediatr Child Health, 2012, 48(2): 106-113.
[18]
Saslow JG, Aghai ZH, Nakhla TA, et al. Work of breathingusing high—flow nasal cannula in preterrn infants[J]. J Perinatol, 2006, 26(8): 476-480.
[19]
Al-Alaiyan S, Dawoud M, Al-Hazzani F. Positive distending pressure produced by heated, humidified high flow nasal cannula as compared to nasal continuous positive airway pressure in premature infants[J]. J Neonatal Perinatal Med, 2014, 7(2): 119-124.
[20]
Lavizzari A, Veneroni C, Colnaghi M, et al. Respiratory mechanics during NCPAP and HHHFNC at equal distending pressures[J]. Arch Dis Child Fetal Neonatal Ed, 2014, 99(4): F315-F320.
[21]
Shoemaker MT, Pierce MR, Yoder BA, et al. High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study[J]. J Perinatol, 2007, 27(2): 85-91.
[22]
Osman M, Elsharkawy A, Abdel-Hady H. Assessment of pain during application of nasal-continuous positive airway pressure and heated, humidified high-flow nasal cannulae in preterm infants[J]. J Perinatol, 2015, 35(4): 263-267.
[23]
Campbell DM, Shah PS, Shah V, et al. Nasal continuous positive airway pressure from high flow cannula versus Infant flow for preterm infants[J]. J Perinatol, 2006, 26(9): 546-549.
[24]
Woodhead DD, Lambert DK, Clark JM, et al. Comparing two methods of delivering high-flow gas therapy by nasal cannula following endotracheal extubation: a prospective, randomized, masked, crossover trial[J]. J Perinatol, 2006, 26(8): 481-485.
