High-flow nasal cannulae and nasal continuous positive airway pressure use in non-tertiary special care nurseries in Australia and New Zealand

Aim: Non-tertiary centres (NTCs) in Australia and New Zealand are increasingly providing non-invasive respiratory support, including high-flow nasal cannulae (HFNC) and nasal continuous positive airway pressure (nCPAP), to newborn infants. We aimed to determine the proportion of NTCs in these countries treating newborn infants with HFNC and nCPAP, and how these therapies are used.

Methods: We surveyed public and private NTCs in Australia and public NTCs in New Zealand. The survey, directed at senior medical and nursing staff, consisted of questions regarding unit demographics, HFNC and nCPAP use.

Results: One hundred seventeen responses were received regarding HFNC use, from 88% (80/91) of public hospitals and 64% (37/58) of private hospitals surveyed. Ten (8.5%) responders (nine public and one private) used HFNC; all used the Fisher & Paykel system. HFNC was used for respiratory distress syndrome from birth (9/10 units), as a weaning mode from nCPAP (5/10 units) and as treatment for apnoea (3/10 units). Flow rates used ranged from 1 to 8 L/min, with typical minimum flow of 1 L/min and maximum of 4-6 L/min. The main perceived advantage of HFNC was 'ease of use'. In the units treating newborn infants with nCPAP, it was used either in an ongoing fashion (43 units), short term or episodically (four units), or only for stabilisation prior to transfer (11 units). Excluding those units using nCPAP only for stabilisation and non-responders, 47/108 (44%) units were using nCPAP.

Conclusions: HFNC is being used in NTCs in Australia and New Zealand, and the use of nCPAP has increased over time.