Original ArticlePredicting Nasal High-Flow Treatment Success in Newborn Infants with Respiratory Distress Cared for in Nontertiary Hospitals
Section snippets
Methods
The HUNTER trial (Australian and New Zealand Clinical Trials Registry ACTRN12614001203640) was conducted in nine Australian SCNs, and compared nasal high-flow delivered at flows of 6-8 L/min with CPAP delivered at pressures of 6-8 cm H2O as primary respiratory support for newborn infants with respiratory distress.6,8 The peripheral oxygen saturation target range was 91%-95% for all infants receiving supplemental oxygen. Infants were eligible to be enrolled in the trial if they were born at
Results
Of the 381 infants randomized to nasal high-flow treatment, 18 infants who never received nasal high-flow were excluded, leaving 363 infants in the analysis (337 singletons and 26 from twins). The cohort (Table I; available at www.jpeds.com) had a mean gestational age of 36.9 ± 2.7 weeks and birth weight of 2928 ± 782 g; 177 infants (49%) were born preterm (<37 weeks of gestation) and 232 (64%) were male. The median age at high-flow treatment commencement was 1.4 hours (IQR, 0.9-2.5 hours), and
Discussion
This study examined predictors of nasal high-flow treatment success in newborn infants enrolled in an RCT of early noninvasive respiratory support in Australian nontertiary SCNs.
In this secondary analysis of the HUNTER trial, predictors of nasal high-flow treatment success on univariable analysis and multivariable analysis included higher gestational age and lower FiO2 immediately before randomization. Nasal high-flow treatment success was not strongly predicted by a model that included these
Data Statement
Data sharing statement available at www.jpeds.com.
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Cited by (4)
Noninvasive respiratory support
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh EditionNasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Today
2021, Clinics in PerinatologyCitation Excerpt :Most studies have reported no adverse events for preterm infants on HFNC and have concluded that the use of HFNC is safe. However, a nationwide survey in Germany reported that 4.5% of clinics experienced greater than three cases of pneumothorax in NICU or pediatric intensive care unit.52 However, clinicians are unable to continuously measure the pressures delivered by HFNC and high pressures have been reported among infants treated with this support.53
Guidelines for high-flow nasal cannula oxygen therapy in neonates (2022)
2023, Journal of Evidence-Based MedicineTrends in the use of non-invasive respiratory support for term infants in tertiary neonatal units in Australia and New Zealand
2022, Archives of Disease in Childhood: Fetal and Neonatal Edition
Supported by the Medical Research Future Fund (Australia) Next Generation Clinical Researchers Career Development Fellowship (1159225 [to B.M.]); National Health and Medical Research Council (Australia), Career Development Fellowship (1159444 [to L.O.]); National Health and Medical Research Council (Australia), Emerging Leadership Grant (1175634 [to C.R.]); National Health and Medical Research Council (Australia), Practitioner Fellowship (1157782 [to P.D.]). The authors declare no conflicts of interest.