Original articleObservational Study of Humidified High-Flow Nasal Cannula Compared with Nasal Continuous Positive Airway Pressure
Section snippets
In Vitro Study
Using a calibrated gas flow analyzer (Fluke Biomedical, Everett, Washington), pressure and gas flow values were analyzed in triplicate at 5 different points within the HFNC system: at the gas flow source, immediately before the pressure-limiting valve, immediately after the pressure-limiting valve, at the end of the HFNC circuit tubing, and at the distal end of the nasal cannula (Figure 1). available at www.jpeds.com). Both the preterm and neonatal cannulas (Fisher & Paykel BC series, 2.4 mm
In Vitro Study
With the HFNC system completely intact with the pressure-limiting valve in place and set at 45 cm H2O, as gas flow was increased, delivered flow was preserved throughout the system, and pressures ranged from 35.7 cm H2O at 1 L/minute to 45.8 cm H2O at 6 L/minute, apparently limited by the pressure-limiting valve (Figure 2; available at www.jpeds.com). Delivered flow and pressure were attenuated distal to the nasal cannula at gas flows ≥ 2 L/minute. Distal to the neonatal nasal cannula, gas flow
Discussion
Despite very limited information on their performance, HFNC systems are being increasingly used for noninvasive neonatal respiratory support. We investigated pressure delivery for one such system both in vitro and in vivo in this observational study of humidified HFNC compared with NCPAP. The main findings in vitro were the demonstrated need for a pressure-limiting valve to control potential excessive pressure delivery, along with a dramatic reduction in the delivered pressures in the face of a
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Cited by (157)
Acute Neonatal Respiratory Disorders
2023, Avery's Diseases of the NewbornNoninvasive respiratory support
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh EditionGuidelines for high-flow nasal cannula oxygen therapy in neonates (2022)
2023, Journal of Evidence-Based Medicine
Financial support for this study was provided by a grant from the Children's Hospitals and Clinics of Minnesota Foundation. The authors declare no conflicts of interest.
This trial was registered at www.clinicaltrials.govNCT00356668