The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial
Objectives: To compare the clinical efficacy of heated, humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) in extremely low-birth-weight preterm infants (ELBWI) after extubation.Methods: This trial included 94 extremely low-birth-weight infants (ELBWI),...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2020-06-01
|
Series: | Frontiers in Pediatrics |
Subjects: | |
Online Access: | https://www.frontiersin.org/article/10.3389/fped.2020.00250/full |
id |
doaj-914cc64187cd4db5a44c6c7df0021c54 |
---|---|
record_format |
Article |
spelling |
doaj-914cc64187cd4db5a44c6c7df0021c542020-11-25T03:18:22ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-06-01810.3389/fped.2020.00250526879The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled TrialJia ChenYingyi LinLanlan DuMengmeng KangXiufang ChiZhu WangYing LiuWeiwei GaoJie YangYunbin ChenObjectives: To compare the clinical efficacy of heated, humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) in extremely low-birth-weight preterm infants (ELBWI) after extubation.Methods: This trial included 94 extremely low-birth-weight infants (ELBWI), within 7 days after birth, and prepared for tracheal extubation and a change to non-invasive ventilation in the neonatal intensive care unit (NICU) admitted to our hospital from January 2015 to December 2018, with 48 infants in the HHHFNC group and 46 infants in the NCPAP group. Reintubation rate within 72 h after initial extubation, total ventilation time, non-invasive ventilation time, total oxygen inhalation time, and the time to reach full enteral feeding were the primary outcome measures. Total intestinal feeding time, average weight gain rate, days of hospitalization, costs of hospitalization, and complication rates, including nasal injury, IVH, BPD, NEC, ROP, and PDA, were used as secondary outcomes. Data were analyzed using Student's t-test or the Mann-Whitney U-test with a Chi-square test or Fisher's exact test, as appropriate, in SPSS (25.0).Results: HHHFNC not only shortened the oxygen exposure time but also effectively reduced the incidence of nasal injury (6.25 vs. 36.96%) and NEC (10.42 vs. 28.26%) (P < 0.05). Additionally, HHHFNC achieved a significant advance in the time to reach full enteral feeding (31.24 ± 11.35 vs. 34.21 ± 14.09 days); increased the average weight gain rate (16.07 ± 3.10 vs. 13.74 ± 4.21) and reduced the days of hospitalization (73.45 ± 18.84 vs. 79.24 ± 19.75), with a lower cost of hospitalization (16.04 ± 3.64 vs.18.79 ± 4.13) thousand dollars (all P < 0.05).Conclusions: Compared with NCPAP, HHHFNC was effective in preventing extubation failure in mechanically ventilated preterm ELBWI. HHHFNC shortens oxygen consumption time and significantly reduces the incidence of nasal injury and necrotizing enterocolitis; moreover, it can also reduce the length of stay and the hospitalization costs.https://www.frontiersin.org/article/10.3389/fped.2020.00250/fullextremely low-birth-weight preterm infantsheated humidified high-flow nasal cannulanasal continuous positive airway pressurepreterm infantrespiratory distress syndrome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jia Chen Yingyi Lin Lanlan Du Mengmeng Kang Xiufang Chi Zhu Wang Ying Liu Weiwei Gao Jie Yang Yunbin Chen |
spellingShingle |
Jia Chen Yingyi Lin Lanlan Du Mengmeng Kang Xiufang Chi Zhu Wang Ying Liu Weiwei Gao Jie Yang Yunbin Chen The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial Frontiers in Pediatrics extremely low-birth-weight preterm infants heated humidified high-flow nasal cannula nasal continuous positive airway pressure preterm infant respiratory distress syndrome |
author_facet |
Jia Chen Yingyi Lin Lanlan Du Mengmeng Kang Xiufang Chi Zhu Wang Ying Liu Weiwei Gao Jie Yang Yunbin Chen |
author_sort |
Jia Chen |
title |
The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial |
title_short |
The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial |
title_full |
The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial |
title_fullStr |
The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial |
title_full_unstemmed |
The Comparison of HHHFNC and NCPAP in Extremely Low-Birth-Weight Preterm Infants After Extubation: A Single-Center Randomized Controlled Trial |
title_sort |
comparison of hhhfnc and ncpap in extremely low-birth-weight preterm infants after extubation: a single-center randomized controlled trial |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2020-06-01 |
description |
Objectives: To compare the clinical efficacy of heated, humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) in extremely low-birth-weight preterm infants (ELBWI) after extubation.Methods: This trial included 94 extremely low-birth-weight infants (ELBWI), within 7 days after birth, and prepared for tracheal extubation and a change to non-invasive ventilation in the neonatal intensive care unit (NICU) admitted to our hospital from January 2015 to December 2018, with 48 infants in the HHHFNC group and 46 infants in the NCPAP group. Reintubation rate within 72 h after initial extubation, total ventilation time, non-invasive ventilation time, total oxygen inhalation time, and the time to reach full enteral feeding were the primary outcome measures. Total intestinal feeding time, average weight gain rate, days of hospitalization, costs of hospitalization, and complication rates, including nasal injury, IVH, BPD, NEC, ROP, and PDA, were used as secondary outcomes. Data were analyzed using Student's t-test or the Mann-Whitney U-test with a Chi-square test or Fisher's exact test, as appropriate, in SPSS (25.0).Results: HHHFNC not only shortened the oxygen exposure time but also effectively reduced the incidence of nasal injury (6.25 vs. 36.96%) and NEC (10.42 vs. 28.26%) (P < 0.05). Additionally, HHHFNC achieved a significant advance in the time to reach full enteral feeding (31.24 ± 11.35 vs. 34.21 ± 14.09 days); increased the average weight gain rate (16.07 ± 3.10 vs. 13.74 ± 4.21) and reduced the days of hospitalization (73.45 ± 18.84 vs. 79.24 ± 19.75), with a lower cost of hospitalization (16.04 ± 3.64 vs.18.79 ± 4.13) thousand dollars (all P < 0.05).Conclusions: Compared with NCPAP, HHHFNC was effective in preventing extubation failure in mechanically ventilated preterm ELBWI. HHHFNC shortens oxygen consumption time and significantly reduces the incidence of nasal injury and necrotizing enterocolitis; moreover, it can also reduce the length of stay and the hospitalization costs. |
topic |
extremely low-birth-weight preterm infants heated humidified high-flow nasal cannula nasal continuous positive airway pressure preterm infant respiratory distress syndrome |
url |
https://www.frontiersin.org/article/10.3389/fped.2020.00250/full |
work_keys_str_mv |
AT jiachen thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yingyilin thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT lanlandu thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT mengmengkang thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT xiufangchi thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT zhuwang thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yingliu thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT weiweigao thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT jieyang thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yunbinchen thecomparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT jiachen comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yingyilin comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT lanlandu comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT mengmengkang comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT xiufangchi comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT zhuwang comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yingliu comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT weiweigao comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT jieyang comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial AT yunbinchen comparisonofhhhfncandncpapinextremelylowbirthweightpreterminfantsafterextubationasinglecenterrandomizedcontrolledtrial |
_version_ |
1724627115537596416 |