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High-flow support in very preterm infants in Australia and New Zealand
C T Roberts1, L S Owen2, B J Manley3
1Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia Critical Care and Neurosciences Division, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
High-flow (HF) therapy is increasingly used for respiratory support in preterm infants. Its adoption in neonatal intensive care units within Australia and New Zealand significantly rose between 2009 and 2012.
Area of Science:
- Neonatal respiratory support
- Pediatric intensive care
- Clinical adoption of medical technologies
Background:
- Randomized trials indicate high-flow (HF) therapy is comparable to continuous positive airway pressure (CPAP) for neonatal postextubation support.
- HF therapy has seen widespread adoption in neonatal intensive care settings.
Purpose of the Study:
- To analyze the trend of high-flow (HF) therapy use in very preterm infants.
- To assess the adoption rate of HF in neonatal intensive care within Australia and New Zealand.
Main Methods:
- A population-based study utilizing the Australian and New Zealand Neonatal Network (ANZNN) dataset.
- Inclusion criteria: very preterm infants (<32 weeks' gestation) receiving respiratory support with HF from 2009 to 2012.
Main Results:
- 3372 very preterm infants received HF therapy.
- HF utilization increased from 15% in 2009 to 35% in 2012.
- In 2012, 53% of extremely preterm infants (<28 weeks' gestation) received HF, with 98% having prior endotracheal ventilation or CPAP.
Conclusions:
- High-flow (HF) therapy use in extremely preterm and very preterm infants demonstrated a significant increase within the ANZNN from 2009 to 2012.
Background:
Randomised trials suggest that high-flow (HF) therapy is comparable with continuous positive airway pressure (CPAP) for postextubation respiratory support in neonates, and HF has been widely adopted in neonatal intensive care.
Methods:
We conducted a population-based study of very preterm infants born <32 weeks' gestation within the Australian and New Zealand Neonatal Network (ANZNN) data set from 2009 to 2012, who received respiratory support with HF.
Results:
3372 very preterm infants were treated with HF. HF use in this population increased significantly from 15% in 2009 to 35% in 2012. In 2012, 53% (542/1029) of extremely preterm infants born <28 weeks' gestation received HF. 98% (3308/3372) of infants had received endotracheal ventilation or CPAP prior to receiving HF. The maximum HF gas flow was ≤8 L/min in almost all infants.
Conclusions:
HF use in extremely preterm and very preterm infants increased significantly within the ANZNN from 2009 to 2012.
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