High flow nasal cannula as a method for rapid weaning from nasal continuous positive airway pressure.

BACKGROUND

To compare two methods of weaning premature infants from nasal continuous positive airway pressure (NCPAP).

METHODS

Between March and November 2012, 88 preterm infants who were stable on NCPAP of 5 cmH2O with FIO2 <30% for a minimum of 6 h were randomly allocated to one of two groups. The high flow nasal cannula (HFNC) group received HFNC with flow of 2 L/min and FIO2 = 0.3 and then stepwise reduction of FIO2 and then flow. The non-HFNC group was maintained on NCPAP of 5 cmH2O and gradual reduction of oxygen until they were on FIO2 = 0.21 for 6 h, and we had weaned them directly from NCPAP (with pressure of 5 cmH2O) to room air.

RESULTS

No significant differences were found between 2 study groups with regards to gestational age, birth weight, Apgar score at 1 and 5 min after birth, patent ductus arteriosus and use of xanthines. The mean duration of oxygen therapy after randomization was significantly lower in HFNC group compared to non-HFNC group (20.6 ± 16.8 h vs. 49.6 ± 25.3 h, P < 0.001). Also, the mean length of hospital stay was significantly lower in HFNC group compared to non-HFNC group (11.3 ± 7.8 days vs. 14.8 ± 8.6 days, P = 0.04). The rate of successful weaning was not statistically different between two groups.

CONCLUSIONS

Weaning from NCPAP to HFNC could decrease the duration of oxygen therapy and length of hospitalization in preterm infants.