Changes in lung aeration with high-flow nasal cannula compared to nasal CPAP in preterm infants.

OBJECTIVE

To compare the degree of atelectasis in preterm infants on nasal continuous airway pressure (nCPAP) versus high-flow nasal cannula (HFNC) at 8 L/min.

STUDY

DESIGN

A cross-over study of infants <29 weeks gestational age (GA) receiving nCPAP and underwent 6-hours of HFNC at 8 L/min before returning to nCPAP. Electrical Impedance Tomography was used to measure lung aeration.

RESULTS

78 infants with median GA of 27 weeks [26, 28] were studied. HFNC was non-inferior to CPAP across the 4 periods (overall mean 2.1 ± 2.9, lower bound of confidence interval -0.9). Infants that failed HFNC had higher dependent silent spaces (DSS) measurements (1.6[0.48, 4.7] vs 0.30[0.0, 2.7], P = 0.046).

CONCLUSION

This study of premature infants <29 weeks GA at birth demonstrated that HFNC was non-inferior to nCPAP as measured by DSS. Infants that failed HFNC had a higher percentage of DSS than those who tolerated HFNC for 6 hours suggesting decreased lung aeration.

CLINICALTRIALS: gov ID: NCT03700606.