Respiratory support with heated humidified high flow nasal cannula in preterm infants

• Published in: Clinical and experimental pediatrics Vol. 59; no. 10; pp. 389 - 394
• Main Author: Jeon, Ga Won
• Format: Journal Article
• Language: English
• Published: Korea (South) Clinical and Experimental Pediatics / Korean Pediatric Society 01.10.2016; The Korean Pediatric Society; Korean Pediatric Society; 대한소아청소년과학회
• Subjects: Airway management; Babies; Bronchopulmonary dysplasia; Gas flow; High flow nasal cannula; Humidity; Metabolism; Newborn babies; Noninvasive ventilation; Patients; Premature babies; Preterm infan; Review; Ventilators; 소아과학; Bronchopulmonary dysplasia; Noninvasive ventilation; Preterm infant; High flow nasal cannula
• ISSN: 1738-1061; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2016.59.10.389

The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.