The Role of Heated Humidified High-flow Nasal Cannula as Noninvasive Respiratory Support in Neonates

Chao, Ke-Yun; Tsai, Li-Yi; Chien, Yu-Hsuan; Mu, Shu‐Chi

doi:10.1016/j.pedneo.2016.08.007

Cited by 18 publications

(20 citation statements)

References 59 publications

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“…7 Despite the lack of data about the use of HHFNC in NICU settings, HHFNC has been widely used because of advantages in terms of fixation techniques, positional problems, and nasal trauma. 8,9 Recent studies have demonstrated that HHFNC is as effective as other non-invasive respiratory support for preterm infants for reducing adverse outcomes. 10 However, there is still insufficient evidence to support the effectiveness and safety of HHFNC in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for treatment failure of heated humidified high-flow nasal cannula as an initial respiratory support in newborn infants with respiratory distress

Lee

Choi

Shin

et al. 2020

Pediatrics & Neonatology

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Background: Humidified high-flow nasal cannula (HHFNC) has gained popularity because it is easier to use, more comfortable for babies, and advantageous for mother-infant bonding. HHFNC is not inferior to other non-invasive ventilators for preventing adverse outcomes, but more studies are needed to ensure the safe use of HHFNC as an initial respiratory support for newborns. The aim of this study was to investigate risk factors for treatment failure of HHFNC as an initial respiratory support in newborns with respiratory distress after birth. Methods: We included 97 newborns who required non-invasive respiratory support within 24 h after birth. The success group included 68 infants who were successfully managed only on HHFNC, and 29 infants were the failure group who required other respiratory support because of respiratory acidosis, hypoxia, or apnea. Results: Compared with the success group, the failure group had lower GA, a higher rate of antenatal steroid use, prolonged rupture of membrane, lower pH, higher pCO 2 on blood-gas analysis after HHFNC application and higher incidence of respiratory distress syndrome of newborn (RDS). After adjusting for GA, higher FiO 2 settings during acidosis, hypercarbia after the application of HHFNC shown on blood-gas analysis and the presence of RDS remained significant. The rate of treatment failure was 16.2% for !36 weeks, 19.3% for !34 weeks, and 22.1% for !33 weeks. Conclusion: Treatment failure of HHFNC should be considered a risk for newborns of less than 34 weeks and infants with respiratory distress from RDS. Higher FiO 2 settings during HHFNC, and acidosis and hypercarbia after the application of HHFNC shown on blood-gas analysis may help identify high-risk newborns for other non-invasive ventilators or intubation.

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Section: Introductionmentioning

confidence: 99%

Risk factors for treatment failure of heated humidified high-flow nasal cannula as an initial respiratory support in newborn infants with respiratory distress

Lee

Choi

Shin

et al. 2020

Pediatrics & Neonatology

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“…[61516] Heated humidified high-flow nasal cannula (HHHFNC) is another technique of respiratory support in neonates with RDS, which is recently considered due to its ease of use, better tolerance, improved nutrition, increased maternal–infant bonding, and less iatrogenic injury. [1718] However, based on the results of the current study, there is still no study on its efficacy as a primary treatment for neonates with RDS. Therefore, the current study aimed at comparing the strength of HHHFNC respiratory management with the standard treatment of RDS disease (NCPAP), as well as noninvasive NIMV technique, and also other primary and secondary clinical outcomes of the three mentioned techniques.…”

Section: Introductionmentioning

confidence: 94%

Heated Humidified High Flow Nasal Cannula (HHHFNC) is not an effective method for initial treatment of Respiratory Distress Syndrome (RDS) versus nasal intermittent mandatory ventilation (NIMV) and nasal continuous positive airway pressure (NCPAP)

et al. 2019

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Background:Noninvasive respiratory support techniques are widely used to treat respiratory distress syndrome (RDS) in preterm infants, and the effectiveness of these methods should be compared. In the current study, nasal continuous positive airway pressure (NCPAP), nasal intermittent mandatory ventilation (NIMV), and heated humidified high-flow nasal cannula (HHHFNC) were compared.Materials and Methods:In the current bicenter clinical trial, 109 preterm infants with RDS not treated with surfactant were randomly assigned to three groups: NCPAP, NIMV, and HHHFNC. The initial outcomes including the failure of treatment within the first initial 72 h, and the duration of RDS treatment, and the secondary outcomes including the need for intubation, the need for surfactants, the duration of oxygen dependency, the incidence of pneumothorax, the patent ductus arteriosus, intraventricular hemorrhage, length of stay, and mortality were compared among the groups.Results:The frequency of HHHFNC treatment failure (54.3%) was significantly higher compared with those of NIMV (21.6%) (P < 0.001, hazard ratio [HR] = 9.12, 95% confidence interval [CI] = 2.59 – 32.07) and NCPAP (35.1%) (P = 0.004, HR = 21.25, 95% CI = 2.51–180.08). The median duration of RDS treatment was longer (40 h) in the HHHFNC group, although it was not significantly different from those of NIMV (31.16 h) and NCPAP (38.91 h).Conclusion:Based on the high prevalence of failure of HHHFNC treatment than the other two methods (NCPAP and NIMV), HHHFNC is not recommended as the initial treatment of RDS.

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“…HFNC improves pulmonary function by providing positive distending pressure [7] to increase functional residual capacity and improve alveolar recruitment [8]. It also provides nasopharyngeal dead space washout, nasopharynx distension [8,9], decreased work of breathing [10], and improves gas exchange. In addition, the warmed, humidified air to the conducting airways improves pulmonary compliance and conductance [5,8].…”

Section: Am J Biomed Sci and Resmentioning

confidence: 99%

Can Warm, Humidified High-Flow Filtered Air Therapy Be Protective Against Severe Infection from Sars-Cov-2 and Other Respiratory Pathogens?

Amatya

2021

AJBSR

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The Role of Heated Humidified High-flow Nasal Cannula as Noninvasive Respiratory Support in Neonates

Cited by 18 publications

References 59 publications

Risk factors for treatment failure of heated humidified high-flow nasal cannula as an initial respiratory support in newborn infants with respiratory distress

Risk factors for treatment failure of heated humidified high-flow nasal cannula as an initial respiratory support in newborn infants with respiratory distress

Heated Humidified High Flow Nasal Cannula (HHHFNC) is not an effective method for initial treatment of Respiratory Distress Syndrome (RDS) versus nasal intermittent mandatory ventilation (NIMV) and nasal continuous positive airway pressure (NCPAP)

Can Warm, Humidified High-Flow Filtered Air Therapy Be Protective Against Severe Infection from Sars-Cov-2 and Other Respiratory Pathogens?

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