Physiological effects of high-flow nasal cannula therapy in preterm infants.
Body Weight
Carbon Dioxide
/ blood
Continuous Positive Airway Pressure
Cross-Over Studies
Female
Humans
Infant, Newborn
Infant, Premature
Male
Oxygen
/ blood
Oxygen Inhalation Therapy
/ methods
Positive-Pressure Respiration
Prospective Studies
Respiratory Distress Syndrome, Newborn
/ therapy
Tidal Volume
Vital Signs
high flow nasal cannula oxygen
neonatology
physiology
respiratory
Journal
Archives of disease in childhood. Fetal and neonatal edition
ISSN: 1468-2052
Titre abrégé: Arch Dis Child Fetal Neonatal Ed
Pays: England
ID NLM: 9501297
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
30
12
2018
revised:
27
04
2019
accepted:
03
05
2019
pubmed:
28
5
2019
medline:
24
12
2019
entrez:
25
5
2019
Statut:
ppublish
Résumé
High-flow nasal cannula (HFNC) therapy is increasingly used in preterm infants despite a paucity of physiological studies. We aimed to investigate the effects of HFNC on respiratory physiology. A prospective randomised crossover study was performed enrolling clinically stable preterm infants receiving either HFNC or nasal continuous positive airway pressure (nCPAP). Infants in three current weight groups were studied: <1000 g, 1000-1500 g and >1500 g. Infants were randomised to either first receive HFNC flows 8-2 L/min and then nCPAP 6 cm H A total of 44 preterm infants, birth weights 500-1900 g, were studied. Increasing flows from 2 to 8 L/min significantly increased pEEP (mean 2.3-6.1 cm H HFNC therapy produces clinically significant pEEP with large variability at higher flow rates. Highest pressures were observed in infants weighing <1000 g. Flow, weight and mouth position are all important determinants of pressures generated. Reductions in pEECO
Identifiants
pubmed: 31123057
pii: archdischild-2018-316773
doi: 10.1136/archdischild-2018-316773
pmc: PMC6951230
doi:
Substances chimiques
Carbon Dioxide
142M471B3J
Oxygen
S88TT14065
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
87-93Subventions
Organisme : Medical Research Council
ID : MR/M008797/1
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: ZL, ACF, SH, SG and CJO’B: none. MB: not related to this work: investigator-led research grants from Pfizer and Roche Diagnostics; speaker fees paid to Newcastle University from Novartis, Roche Diagnostics and TEVA. Travel expenses to educational meeting Boehringer Ingelheim and Vertex Pharmaceuticals.
Références
J Pediatr. 2016 Nov;178:309
pubmed: 27522445
J Perinatol. 2006 Aug;26(8):476-80
pubmed: 16688202
Pediatrics. 2008 Jan;121(1):82-8
pubmed: 18166560
ERJ Open Res. 2016 Nov 24;2(4):
pubmed: 28053968
J Appl Physiol (1985). 2017 Jan 1;122(1):191-197
pubmed: 27856714
Arch Dis Child Fetal Neonatal Ed. 2016 Jul;101(4):F371-2
pubmed: 27173417
J Appl Physiol (1985). 2013 Apr;114(8):1058-65
pubmed: 23412897
J Pediatr. 2009 Feb;154(2):177-82
pubmed: 18760803
Cochrane Database Syst Rev. 2016 Feb 22;2:CD006405
pubmed: 26899543
Intensive Care Med. 2013 Jun;39(6):1088-94
pubmed: 23494016
J Intensive Care Med. 2009 Sep-Oct;24(5):323-8
pubmed: 19703816
Pediatr Pulmonol. 2011 Jan;46(1):67-74
pubmed: 21171186
J Appl Physiol (1985). 2015 Jun 15;118(12):1525-32
pubmed: 25882385
Neonatology. 2018;113(3):235-241
pubmed: 29393237
Arch Dis Child Fetal Neonatal Ed. 2017 Mar;102(2):F173-F175
pubmed: 28213557
Acta Paediatr. 2014 Sep;103(9):898-903
pubmed: 24844683
N Engl J Med. 2016 Sep 22;375(12):1142-51
pubmed: 27653564
Crit Care Res Pract. 2016;2016:8041967
pubmed: 27375901
J Perinatol. 2007 Dec;27(12):772-5
pubmed: 17762844
Pediatr Pulmonol. 2017 Jun;52(6):792-798
pubmed: 28165671
Respir Med. 2009 Oct;103(10):1400-5
pubmed: 19467849
J Perinatol. 2008 Jan;28(1):42-7
pubmed: 17989697
Am J Respir Crit Care Med. 2017 May 1;195(9):1207-1215
pubmed: 27997805
Pediatrics. 2001 May;107(5):1081-3
pubmed: 11331690
Pediatrics. 2015 Sep;136(3):542-53
pubmed: 26283781
Eur Respir J. 2018 May 30;51(5):
pubmed: 29724917
J Perinatol. 2008 Nov;28(11):779-81
pubmed: 18974751
Crit Care Med. 2017 Dec;45(12):1981-1988
pubmed: 28857852
J Appl Physiol (1985). 2017 Jan 1;122(1):82-88
pubmed: 27815367
Pediatr Emerg Care. 2012 Nov;28(11):1179-84
pubmed: 23114244
Arch Dis Child Fetal Neonatal Ed. 2014 Jul;99(4):F315-20
pubmed: 24786469
J Pediatr. 2016 Jun;173:50-55.e1
pubmed: 27004673