Document Detail


High-flow nasal cannulae in the management of apnea of prematurity: a comparison with conventional nasal continuous positive airway pressure.
MedLine Citation:
PMID:  11331690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Apnea of prematurity (AOP) is frequently managed with nasal continuous positive airway pressure (NCPAP). Nasal cannula (NC) are used at low flows (<0.5 L/min) to deliver supplemental oxygen to neonates. A number of centers use high-flow nasal cannula (HFNC) in the management of AOP without measuring the positive distending pressure (PDP) generated. Objective. To determine the NC flow required to generate PDP equal to that provided by NCPAP at 6 cm H(2)O and to assess the effectiveness of HFNC as compared NCPAP in the management of AOP. Method. Forty premature infants, gestation 28.7 +/- 0.4 weeks (mean +/- standard error of mean), postconceptual age at study 30.3 +/- 0.6 weeks, birth weight 1256 +/- 66 g, study weight 1260 +/- 63 g who were being managed with conventional NCPAP for at least 24 hours for clinically significant apnea of prematurity, were enrolled in a trial of ventilator-generated conventional NCPAP versus infant NC at flows of up to 2.5 L/min. End expiratory esophageal pressure was measured on NCPAP and on NC, and the gas flow on NC was adjusted to generate an end expiratory esophageal pressure equal to that measured on NCPAP. Two 6-hour periods were continuously recorded and the data were stored on computer. Results. The flow required to generate a comparable PDP with NC varied with the infant's weight and was represented by the equation: flow (L/min) = 0.92 + 0.68x, x = weight in kg, R = 0.72. There was no difference in the frequency and duration of apnea, bradycardia or desaturation per recording between the 2 systems. Conclusion. NC at flows of 1 to 2.5 L/min can deliver PDP in premature neonates. HFNC is as effective as NCPAP in the management of AOP.
Authors:
C Sreenan; R P Lemke; A Hudson-Mason; H Osiovich
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  107     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-24     Completed Date:  2001-07-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1081-3     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Intensive Care Unit, Royal Alexandra Hospital, University ofAlberta, Edmonton, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Apnea / physiopathology,  therapy*
Bradycardia
Bronchodilator Agents / therapeutic use
Cross-Over Studies
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / therapy*
Intubation / instrumentation*
Nasal Cavity
Oxygen Consumption
Positive-Pressure Respiration / instrumentation*,  methods
Theophylline / therapeutic use
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 58-55-9/Theophylline
Comments/Corrections
Comment In:
Pediatrics. 2002 Apr;109(4):718-9; author reply 718-9   [PMID:  11927724 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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