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

Abstract

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 that nasal CPAP may provide more effective respiratory support.

A randomised cross‐over study showed no difference in diaphragm activity during weaning from respiratory support

“…In our study, there was a large variability in the recorded data of the Edi signals in each included child. This variability has also been observed in other studies (14,24), and we can only speculate about whether this variability was due to prematurity, underlying diagnoses or complications during the neonatal period. Further discussion of this topic would, however, exceed the scope of this paper.…”

Work of breathing during CPAP and heated humidified high-flow nasal cannula

“…Of note, however, there was no significant difference in the oxygen saturation levels between the two modes 11. We used higher flow rates during HHFNC than in the previous study 11. We recruited 20 of 30 eligible infants, but those recruited did not differ significantly with regard to gestational age or birthweight from those not recruited, hence we feel our results are generalisable.…”

“…Assessment of 10 very low birthweight infants in a crossover design study of 2 h on HHFNC (mean flow rate of 4.8 or 5.4 L/min) or CPAP (5 cm H 2 O) demonstrated greater diaphragmatic activity on HHFNC, thus suggesting that nCPAP was providing more effective respiratory support. Of note, however, there was no significant difference in the oxygen saturation levels between the two modes 11. We used higher flow rates during HHFNC than in the previous study 11.…”

Electrical activity of the diaphragm during nCPAP and high flow nasal cannula

“…Nasef et al 26 measured in a smaller study electrical activity of the diaphragm by transoesophageal dEMG in preterm infants crossing over between nCPAP using a mean pressure of 5 cmH 2 O and HFNC with a mean flow rate of 5 L/min. Comparable with our results, they did not find differences in diaphragmatic activity between nCPAP and HFNC.…”