A Comparative Study between Postextubation of Preterm Infants into High-Flow Nasal Cannulae versus Nasal Continuous Positive Airway Pressure

Abstract

Background and Aim of work: To support breathing of premature infants, there has been a trend toward less tracheal intubation, less mechanical ventilation, and more nasal respiratory support which can result in the improvement of successful extubation rate. The two types of nasal respiratory support after extubation, which are most known, are the nasal CPAP and High flow nasal cannula. The objective of current study is to investigate and compare successful extubation by using high-flow nasal cannulae (HFNC) versus conventional NCPAP after a period of endotracheal positive pressure ventilation. Patients and methods: This prospective study was conducted in the NICU of Gynecology and Obstetrics department of Kasr El Aini hospital on 210 preterm infants. Post extubation failure rates were compared between both groups (HFNC) and (NCPAP). The collected data were analyzed by SPSS program version 20.Results: Neonates who needed reintubation within 72 hour after initial extubation were higher in HFNC group (72.7%) versus (27.3%) in CPAP group (P-value 0.063) and (45.8%) of neonates in HFNC group needed re-intubation within one week of initial extubation versus (54.2%) in CPAP (P-value 0.970). Mean duration of respiratory support using HFNC was 3.7 days compared with 6.5 days using CPAP (p-value 0.001). Among neonates who suffered nasal trauma 90.6% of infants belong to CPAP group 12.5% while 9.4% belong to HFNC group (p-value 0.001). Conclusion: The use of CPAP and HFNC after extubation of preterm mechanically ventilated neonates was statistically equal regarding extubation failure.