High-flow oxygen therapy in preterm infants ≤ 32 weeks in a tertiary care hospital: Retrospective descriptive study and association with bronchopulmonary dysplasia and retinopathy of prematurity

Abstract

Introduction

High-flow oxygen therapy (HFOT) is increasingly used for respiratory support in preterm newborns (PTNBs). However, there is still limited evidence regarding the impact of its early and prolonged use in this population, as well as its association with clinical outcomes such as bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). The aim of our study was to describe our experience with the use of HFOT in PTNBs and to analyze its association with the prevalence of BDP and ROP.

Material and methods

Retrospective descriptive study conducted in a cohort of PTNBs born between May 2019 and May 2024 with gestational age ≤ 32 weeks who received HFOT during their stay in the neonatal intensive care unit of a tertiary care hospital. We analyzed data on variables related to HFOT exposure (duration, maximum flow, and FiO₂) and the presence of BPD and ROP.

Results

In the analyzed cohort, we found a potential association between HFOT exposure parameters (days of use, maximum flow, and FiO₂) and the presence of BPD. Likewise, we found evidence of a potential negative impact, as the duration of HFOT and the FiO₂ were associated with the presence of ROP. The frequency of both complications increased with lower gestational age and lower birth weight.

Conclusions

In this cohort, we observed a possible negative impact of the use of HFNC on the development of BPD and ROP, which was more evident in infants with lower gestational ages and birth weights. These findings should be interpreted with caution due to the descriptive design of the study and the lack of a comparison group, and analytical studies with appropriate control groups are required to further investigate these associations.