Deeparaj Hegde1, Jayashree Mondkar, Harshad Panchal, Swati Manerkar, Bonny Jasani, Nandkishor Kabra. 1. Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal and General Hospital, and #Department of Neonatology, Seth GS Seth Medical college and KEM Hospital; Mumbai, India. Correspondence to: Dr Deeparaj Hegde, Department of Neonatology, LTMMC and LTMG hospital, Sion (West), Mumbai, India. princedeepraj81@gmail.com.
Abstract
OBJECTIVE: To compare the outcomes of preterm infants with respiratory distress initiated on either Heated Humidified High Flow Nasal Cannula or Nasal Continuous Positive Airway Pressure as a primary mode of respiratory support. STUDY DESIGN: Prospective observational cohort study. SETTING: Tertiary care level III neonatal intensive care unit. PARTICIPANTS: 88 preterm infants between 28 to 34 weeks of gestation with mild to moderate respiratory distress within 6 hours of birth. INTERVENTION: Eligible infants were treated either with Heated Humidified High Flow Nasal Cannula (n=46) or Nasal Continuous Positive Airway Pressure (n=42). PRIMARY OUTCOME: Need for mechanical ventilation within 72 hrs of initiating support. RESULTS: Baseline demographic characteristics were comparable between the two groups. There was no difference in the requirement of mechanical ventilation between Heated Humidified High Flow Nasal Cannula (19.5%) and Nasal Continuous Positive Airway Pressure (26.2%) groups [RD-0.74 (95% CI 0.34-1.62; P =0.46)]. Moderate or severe nasal trauma occurred less frequently with Heated Humidified High Flow Nasal Cannula (10.9%) in comparison to Nasal Continuous Positive Airway Pressure (40.5%) (P= 0.004). CONCLUSIONS: Heated Humidified High Flow Nasal Cannula was comparable to Nasal Continuous Positive Airway Pressure as a primary respiratory support for preterm infants with respiratory distress, with lesser incidence of nasal trauma.
OBJECTIVE: To compare the outcomes of preterm infants with respiratory distress initiated on either Heated Humidified High Flow Nasal Cannula or Nasal Continuous Positive Airway Pressure as a primary mode of respiratory support. STUDY DESIGN: Prospective observational cohort study. SETTING: Tertiary care level III neonatal intensive care unit. PARTICIPANTS: 88 preterm infants between 28 to 34 weeks of gestation with mild to moderate respiratory distress within 6 hours of birth. INTERVENTION: Eligible infants were treated either with Heated Humidified High Flow Nasal Cannula (n=46) or Nasal Continuous Positive Airway Pressure (n=42). PRIMARY OUTCOME: Need for mechanical ventilation within 72 hrs of initiating support. RESULTS: Baseline demographic characteristics were comparable between the two groups. There was no difference in the requirement of mechanical ventilation between Heated Humidified High Flow Nasal Cannula (19.5%) and Nasal Continuous Positive Airway Pressure (26.2%) groups [RD-0.74 (95% CI 0.34-1.62; P =0.46)]. Moderate or severe nasal trauma occurred less frequently with Heated Humidified High Flow Nasal Cannula (10.9%) in comparison to Nasal Continuous Positive Airway Pressure (40.5%) (P= 0.004). CONCLUSIONS: Heated Humidified High Flow Nasal Cannula was comparable to Nasal Continuous Positive Airway Pressure as a primary respiratory support for preterm infants with respiratory distress, with lesser incidence of nasal trauma.