Non-invasive respiratory support for preterm infants

Bronchopulmonary dysplasia continues to be a hard outcome to shift. Avoiding mechanical ventilation is an important strategy and there are now so many approaches to this that determining the best approach or combination can seem practically impossible. Peter Reynolds and colleagues expand the range of options further by demonstrating the feasibility of starting heated humidified high flow nasal cannula therapy (sometimes also known as nasal high flow) in the delivery room. Their preliminary results are impressive, including some very immature infants. Others will surely want to evaluate this more widely. In an accompanying editorial, Brett Manley cautions that a nasal high flow “pandemic” must be contained pending further evidence from randomised controlled trials. A survey of practice by Sandeep Shetty and colleagues shows the dramatic increase in popularity of nasal high flow therapy in the UK since 2012.

Mehmet Oncel and …