HHFNC shortens NCPAP time without increasing overall length of non-invasive respiratory support in very preterm infants. Unlike NCPAP, HHFNC does not seem to increase the risk of nasal trauma and appears to improve cost-effectiveness whilst producing otherwise equal respiratory and non-respiratory outcomes.

Bilateral multiple subependymal pseudocysts or choroid plexus cysts suggest an underlying disease. Further investigations should be undertaken even if the patient is otherwise normal. Parents of well newborns with a single cyst should be reassured.

What is already known on this topic? Poor growth attainment in early childhood and early adolescence has been reported for extremely preterm survivors. Growth data beyond adolescence are scarce in such populations. What this study adds? EP participants remained shorter and lighter and had smaller head circumferences than reference data or term-born controls in adulthood, despite catch-up growth. Trajectories in height and head circumference were similar in EP and control participants, but weight, and therefore BMI, rose faster among EP individuals.  Birth characteristics and neonatal feeding practices were related to growth over childhood to 19 years. AbstractObjective: To investigate growth trajectories from age 2.5 to 19 years in individuals born before 26 weeks of gestation (extremely preterm; EP) compared with term-born controls.Methods: Multilevel modelling of growth data from the EPICure Study, a prospective 1995 birth cohort of 315 participants born in the UK and Ireland and 160 term-born controls recruited at school age. Height, weight, head circumference and body mass index (BMI) z-scores were derived from UK standards at age 2.5, 6, 11 and 19 years.Results: 129 (42%) EP children were assessed at 19 years. EP individuals were on average 4.0 cm shorter and 6.8kg lighter with a 1.5 cm smaller head circumference relative to controls at 19 years.Relative to controls, EP participants grew faster in weight by 0.06 SD per year (95% CI 0.05 to 0.07), in head circumference by 0.04 SD (0.03 to 0.05), but with no catch-up in height. For the EP group, because of weight catch up between 6 and 19 years, BMI was significantly elevated at 19 years to +0.32 SD; 23.4% had BMI>25 kg/m 2 and 6.3% >30 kg/m 2 but these proportions were similar to those in control subjects. EP and control participants showed similar pubertal development in early adolescence, which was not associated with height at 19y in either study group. Growth through childhood was related to birth characteristics and to neonatal feeding practices.Conclusions: EP participants remained shorter and lighter and had smaller head circumferences than reference data or controls in adulthood but had elevated BMI.Word count: 250/250

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Introduction Current evidence supports nasal continuous positive airway pressure (NCPAP) weaning. Heated humidified high‐flow nasal cannula (HHFNC) reduces NCPAP time in infants less than 28 weeks gestational age (GA) without increasing morbidity. The aim of the study was to compare the two most frequently used HHFNC devices in weaning from NCPAP. Methodology We performed a retrospective matched‐pair case‐control study of infants less than or equal to 28 GA born in a single tertiary neonatal center managed with Optiflow or Vapotherm after being weaned from NCPAP. Patients were matched for antenatal steroid doses, delivery mode, birth plurality, GA, birthweight, gender, surfactant doses, length of mechanical ventilation, and length of NCPAP. Outcome measures were duration of HHFNC, low‐flow nasal cannula, nasal bridge lesions, pneumothorax, bronchopulmonary dysplasia, postnatal steroids, necrotizing enterocolitis, sepsis, intraventricular hemorrhage, retinopathy of prematurity, length of stay, discharge weight, and mortality. Results were displayed as median (interquartile range) or ratio (percentage). Statistical analysis was performed using Mann‐Whitney U and χ2 tests. Results 70 patients were recruited retrospectively. Thirty‐five infants were weaned from NCPAP to Optiflow and 35 infants to Vapotherm with gestational ages and birthweights of 27 GA (26‐27) and 1010 g (835‐1165) and 27 GA (26‐28) and 960 g (788‐1191), respectively. There was no statistically significant difference in any outcome measure. Infants managed with Vapotherm required a not statistically significant shorter length of time on HHFNC and low‐flow nasal cannula. Conclusions Optiflow and Vapotherm seem to be equally effective and safe for weaning from NCPAP. However, infants weaned to Vapotherm appear to spend less time on non‐invasive respiratory support.