Nasal high flow therapy for primary respiratory support in preterm infants

Hodgson, Kate; Wilkinson, Dominic; Paoli, Antonio G De; Manley, Brett J.

doi:10.1002/14651858.cd006405.pub4

Cited by 6 publications

(3 citation statements)

References 81 publications

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“…The primary outcomes evaluated in most of these systematic reviews were quite variable. The Cochrane review reported on the outcomes of risk of mortality or BPD, mortality, BPD, treatment failure within the first 72 h and the need for IMV ( 80 ). The authors found that the use of HHHFNC as a primary respiratory support did not result in any significant difference in most of the outcomes except for a higher treatment failure rate in the HHHFNC group when compared to the CPAP group.…”

Section: Cpapmentioning

confidence: 99%

Non-invasive ventilation in neonates: a review of current literature

Ramaswamy,

Devi,

Kumar

2023

Front. Pediatr.

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Moving from an era of invasive ventilation to that of non-invasive respiratory support, various modalities have emerged resulting in improved neonatal outcomes. Respiratory distress is the commonest problem seen both in preterm and term neonates, and the use of appropriate respiratory support could be lifesaving. This article reviews the currently available non-invasive ventilation (NIV) strategies in neonates including nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation (NIPPV), bi-level CPAP, heated humidified high flow nasal cannula, nasal high-frequency ventilation (NHFV) and non-invasive neutrally adjusted ventilatory assist (NIV-NAVA). Though multiple systematic reviews and meta-analyses have indicated the superiority of synchronized NIPPV over the other forms of non-invasive respiratory support in neonates, there is no single NIV modality that universally suits all. Hence, the choice of NIV for a neonate should be individualized based on its efficacy, the disease pathology, resource settings, the clinician's familiarity and parental values. Future studies should evaluate emerging modalities such as NIV-NAVA and NHFV in the respiratory management of neonates as the evidence pertaining to these is insufficient.

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Section: Cpapmentioning

confidence: 99%

Non-invasive ventilation in neonates: a review of current literature

Ramaswamy,

Devi,

Kumar

2023

Front. Pediatr.

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“…9 Additionally, the use of HHHFNCs is associated with significantly decreased nasal trauma. 10 However, the inability to monitor the distending pressure created by increased flow poses a risk of overdistension and lung injury. 10 …”

Section: Introductionmentioning

confidence: 99%

“… 10 However, the inability to monitor the distending pressure created by increased flow poses a risk of overdistension and lung injury. 10 …”

Section: Introductionmentioning

confidence: 99%

Use of High-Flow Nasal Cannulas in Saudi’s Neonatal Level III Intensive Care Units: A Nationwide Questionnaire Study

Algarni,

Alshammari,

Alkhalifah

et al. 2024

Global Pediatric Health

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Objective. To describe heated humidified high-flow nasal cannulas (HHHFNC) utilization in level III neonatal intensive care units (NICUs) in Saudi Arabia. Methods. A prospective cross-sectional study using an electronic web-based questionnaire. The survey targeted level III NICUs hospitals using HHHFNCs, covering HHHFNC availability, protocols, patient characteristics, and indications. It also collected opinions on the benefits of HHHFNCs compared to nasal continuous positive airway pressure (nCPAP). Results. Out of 47 government-level III neonatal intensive care units, 35 (74%) responded to the survey. Among the included units, 46% had guidelines for HHHFNC use. Additionally, 51% reported using HHHFNC in infants of all gestational ages. The primary indication for HHHFNC use was weaning off nCPAP (34%), with 60% of the respondents noting its advantages for kangaroo care and breastfeeding. Conclusion. HHHFNC are increasingly prevalent in NICUs in Saudi Arabia. However, there remain no clear policies or guidelines regarding their use in preterm infants.

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Non-invasive high-frequency ventilation in newborn infants with respiratory distress

Abdel-Latif,

Tan,

Fiander

et al. 2024

Cochrane Database of Systematic Reviews

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Background Respiratory distress occurs in up to 7% of newborns, with respiratory support (RS) provided invasively via an endotracheal (ET) tube or non‐invasively via a nasal interface. Invasive ventilation increases the risk of lung injury and chronic lung disease (CLD). Using non‐invasive strategies, with or without minimally invasive surfactant, may reduce the need for mechanical ventilation and the risk of lung damage in newborn infants with respiratory distress. Objectives To evaluate the benefits and harms of nasal high‐frequency ventilation (nHFV) compared to invasive ventilation via an ET tube or other non‐invasive ventilation methods on morbidity and mortality in preterm and term infants with or at risk of respiratory distress. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL and three trial registries in April 2023. Selection criteria Randomised controlled trials (RCTs), cluster‐ or quasi‐RCTs of nHFV in newborn infants with respiratory distress compared to invasive or non‐invasive ventilation. Data collection and analysis Two authors independently selected the trials for inclusion, extracted data, assessed the risk of bias, and undertook GRADE assessment. Main results We identified 33 studies, mostly in low‐ to middle‐income settings, that investigated this therapy in 5068 preterm and 46 term infants. nHFV compared to invasive respiratory therapy for initial RS We are very uncertain whether nHFV reduces mortality before hospital discharge (RR 0.67, 95% CI 0.20 to 2.18; 1 study, 80 infants) or the incidence of CLD (RR 0.38, 95% CI 0.09 to 1.59; 2 studies, 180 infants), both very low‐certainty. ET intubation, death or CLD, severe intraventricular haemorrhage (IVH) and neurodevelopmental disability (ND) were not reported. nHFV vs nasal continuous positive airway pressure (nCPAP) used for initial RS We are very uncertain whether nHFV reduces mortality before hospital discharge (RR 1.00, 95% CI 0.41 to 2.41; 4 studies, 531 infants; very low‐certainty). nHFV may reduce ET intubation (RR 0.52, 95% CI 0.33 to 0.82; 5 studies, 571 infants), but there may be little or no difference in CLD (RR 1.35, 95% CI 0.80 to 2.27; 4 studies, 481 infants); death or CLD (RR 2.50, 95% CI 0.52 to 12.01; 1 study, 68 participants); or severe IVH (RR 1.17, 95% CI 0.36 to 3.78; 4 studies, 531 infants), all low‐certainty evidence. ND was not reported. nHFV vs nasal intermittent positive‐pressure ventilation (nIPPV) used for initial RS nHFV may result in little to no difference in mortality before hospital discharge (RR 1.86, 95% CI 0.90 to 3.83; 2 studies, 84 infants; low‐certainty). nHFV may have little or no effect in reducing ET intubation (RR 1.33, 95% CI 0.76 to 2.34; 5 studies, 228 infants; low‐certainty). There may be a reduction in CLD (...

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Nasal high flow therapy for primary respiratory support in preterm infants

Cited by 6 publications

References 81 publications

Non-invasive ventilation in neonates: a review of current literature

Non-invasive ventilation in neonates: a review of current literature

Use of High-Flow Nasal Cannulas in Saudi’s Neonatal Level III Intensive Care Units: A Nationwide Questionnaire Study

Non-invasive high-frequency ventilation in newborn infants with respiratory distress

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