As published in the New England Journal of Medicine, “High-Flow Nasal Cannulae in Very Preterm Infants after Extubation”, subtle differences matter when it comes to premature babies. Although the result for the primary outcome was close to the margin of noninferiority, the efficacy of high-flow nasal cannulae was similar to that of CPAP as respiratory support for very preterm infants after extubation.
Treatment failure occurred at a rate of 34.2% with the high-flow nasal cannulae and 25.8% with CPAP, Manley and colleagues found. That comparison met non-inferiority criteria, though narrowly so, as reported in the Oct. 10 issue of the New England Journal of Medicine.
Alan Lantzy, MD, vice-chair of pediatrics at West Penn Hospital in Pittsburgh, stated that, “More neonatal units and more neonatologists will be convinced that their switch from CPAP to high-flow nasal cannulae after extubation is evidence-based.”
At least two-thirds of U.S. academic center neonatal ICUs have reportedly already switched to high-flow nasal cannulae that deliver more than 1 L/min of heated, humidified air through small prongs, and the strategy is increasingly popular in other countries too, Manley’s group noted.
“Because high-flow nasal cannulae have a simpler interface with the infant and smaller prongs than nasal CPAP, the cannulae are perceived as easier to use, more comfortable for the infant, and advantageous for mother-infant bonding,” added Manley and his team.