Abstract
Objectives: To compare the clinical efficacy of heated, humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) in extremely low-birth-weight preterm infants (ELBWI) after extubation.Methods: This trial included 94 extremely low-birth-weight infants (ELBWI), within 7 days after birth, and prepared for tracheal extubation and a change to non-invasive ventilation in the neonatal intensive care unit (NICU) admitted to our hospital from January 2015 to December 2018, with 48 infants in the HHHFNC group and 46 infants in the NCPAP group. Reintubation rate within 72 h after initial extubation, total ventilation time, non-invasive ventilation time, total oxygen inhalation time, and the time to reach full enteral feeding were the primary outcome measures. Total intestinal feeding time, average weight gain rate, days of hospitalization, costs of hospitalization, and complication rates, including nasal injury, IVH, BPD, NEC, ROP, and PDA, were used as secondary outcomes. Data were analyzed using Student's t-test or the Mann-Whitney U-test with a Chi-square test or Fisher's exact test, as appropriate, in SPSS (25.0).Results: HHHFNC not only shortened the oxygen exposure time but also effectively reduced the incidence of nasal injury (6.25 vs. 36.96%) and NEC (10.42 vs. 28.26%) (P < 0.05). Additionally, HHHFNC achieved a significant advance in the time to reach full enteral feeding (31.24 ± 11.35 vs. 34.21 ± 14.09 days); increased the average weight gain rate (16.07 ± 3.10 vs. 13.74 ± 4.21) and reduced the days of hospitalization (73.45 ± 18.84 vs. 79.24 ± 19.75), with a lower cost of hospitalization (16.04 ± 3.64 vs.18.79 ± 4.13) thousand dollars (all P < 0.05).Conclusions: Compared with NCPAP, HHHFNC was effective in preventing extubation failure in mechanically ventilated preterm ELBWI. HHHFNC shortens oxygen consumption time and significantly reduces the incidence of nasal injury and necrotizing enterocolitis; moreover, it can also reduce the length of stay and the hospitalization costs.
Highlights
The birth and survival rates of premature infants, especially extremely low-birth-weight infants (ELBWI), have brought about gradual increases in short- and long-term complications
This study investigated the clinical efficacy of HHHFNC compared with Nasal continuous positive airway pressure (NCPAP) for ELBWI, aiming to explore a more effective mode of non-invasive ventilation for ELBWI
The ventilator parameters of the HHHFNC group were reduced to flow
Summary
The birth and survival rates of premature infants, especially extremely low-birth-weight infants (ELBWI), have brought about gradual increases in short- and long-term complications. The establishment of good ventilation after birth is the basis for the survival of premature infants, especially for ELBWI. Both the earlier gestational age and the lower birth weight can make it difficult to establish spontaneous breathing and may increase the incidence of respiratory distress [1]. Extubation is recommended as soon as possible for neonates, especially premature babies, to avoid the potential damages caused by invasive ventilation as much as possible. Non-invasive ventilation after extubation helps prevent possible apnoea, respiratory failure, and re-intubation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
