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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Work of breathing using high-flow nasal cannula in preterm infants
J G Saslow1, Z H Aghai, T A Nakhla
1Division of Neonatology, Department of Pediatrics, The Children's Regional Hospital at Cooper University Hospital, Camden, NJ 08103, USA. saslow-judy@cooperhealth.edu
Objective:
To compare the work of breathing (WOB) in premature neonates supported with high-flow nasal cannula (HFNC) and nasal continuous positive airway pressure (NCPAP).
Study Design:
Eighteen preterm neonates <2.0 kg on HFNC or NCPAP support were studied in a random order. A ventilator was used to deliver 6 cm H2O of NCPAP with nasal prongs. High-flow nasal cannula delivered with Vapotherm (VAPO) at 3, 4 and 5 l/min was used. Tidal ventilation was obtained using respiratory inductance plethysmography calibrated with face-mask pneumotachography. An esophageal balloon estimated pleural pressure from which changes in end distending pressure were calculated. Inspiratory, elastic and resistive WOB and respiratory parameters were calculated.
Results:
No differences were found in the WOB for all settings. Changes in end distending pressure did not vary significantly over all device settings except VAPO at 5 l/min.
Conclusion:
In these preterm infants with mild respiratory illness, HFNC provided support comparable to NCPAP.
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