Original scientific paper
https://doi.org/10.22514/SV132.102017.4
Admission to NICU in air is more likely if nasal High Flow is used for stabilisation in preterm babies compared to face mask CPAP
PETER REYNOLDS
; Neonatal Intensive Care Unit,St. Peter’s Hospital, Ashford and St. Peter’s Hospitals NHS Foundation Trust, Surrey, UK
EDIT MOLNAR
NICOLA HOLLAND
Abstract
Objective. To examine the success of stabilisation
and the short term outcomes from
the routine use of nasal high flow (nHF) on
an unselected cohort of babies in the delivery
room (DR).
Design. Retrospective single-centre study
Setting. Single-centre neonatal intensive
care unit (NICU)
Patients. Infants born at < 32 weeks gestation
Interventions. Stabilisation and transfer to
NICU of an unselected cohort of babies using
nHF
Main outcome measures. Success of stabilisation
defined by successful transfer
on nHF and clinical measures of stability
at admission to NICU, including oxygen
requirement, admission temperature, surfactant
requirement, short term outcomes
and whether infants were sustained on
nHF by 72 hours of age.
Results. There were 133 eligible babies.
54 were commenced on nHF in the DR
(Group A), 47 were stabilised by face
mask CPAP (continuous positive airway
pressure) (Group B), 26 were intubated
(Group C); 6 required only minimal respiratory
support (Group D). Median maturity
varied between the groups (Group
A 27+5 weeks, Group B 30 weeks, Group
C 26+2 weeks, Group D 31+5). 72% of
Group A and 75% of Group B remained
on nHF for 72 hours (P=0.82). Fewer babies
received surfactant in Group A versus
Group B (29% vs 35%; P=0.67), however
groups were not matched for maturity differences
and Group A were significantly
less mature and of lower birthweight (both
P<0.001). Group A were significantly more
likely to be in air at admission than Group
B (P=0.03).
Conclusion. Preterm babies can be successfully
stabilised and sustained on nHF.
The use of nHF for immediate stabilisation
appears to be effective and, in this study,
led to significantly more babies being in
air on admission to the NICU compared to
face mask CPAP stabilisation.
Keywords
nasal High Flow cannula; delivery room; stabilisation; premature
Hrčak ID:
190590
URI
Publication date:
12.12.2017.
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