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Objective:To explore the effects of different initial flow rates of humidified high flow nasal cannula oxygen therapy on weaning outcomes and comfort level among ICU patients with difficult weaning.Methods:A total of 99 ICU patients with difficult weaning received at Guangzhou Red Cross Hospital ICU from June 2019 to June 2021 were enrolled in the present study, they were assigned to 40 L/min group, 50 L/min group and 60 L/min group according to the random number table method, with 33 cases in each group. The weaning outcomes among three groups were compared, the degree of dryness of oral/nasal cavity, throat pain as well as vital signs and blood gas indexes were also compared before extubation and 30 min after the first humidified high flow nasal cannula (HHFNC) oxygen therapy.Results:There was no significant difference in length of stay in ICU and hospital, re-intubation within 7 days, the mortality within 28 days in ICU and the hospital among three groups ( P>0.05). The weaning success rate were 78.8% (24/33) and 77.4% (23/31) in 50 L/min group and 60 L/min, higher than in the 40 L/min group 53.1% (17/32), the difference was statistically significant ( χ2=4.78, 4.09, both P<0.05). After oxygen therapy, the scores of dryness of oral/nasal cavity and throat pain in the 40 L/min group, 50 L/min group and 60 L/min group were (3.16 ± 0.77), (2.94 ± 0.80) and (3.27 ± 0.92), (3.09 ± 0.77), and (4.10 ± 1.01), (3.97 ± 1.40), the differences were statistically significant ( F=5.21, 9.26, both P<0.05), and the differences between 50 L/min group and 40 L/min group and 60 L/min group were statistically significant ( t values were 2.62-3.99, all P<0.05). However, there was no significant difference in vital signs and blood gas indexes among the three groups before extubation and after oxygen therapy ( P>0.05). Conclusions:Humidified high flow nasal cannula oxygen therapy for the ICU patients with difficult weaning, oxygen flow with 50L/min can not only effectively promote weaning success rate but also improve patients′ respiratory comfort level.
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Objective:To analyze the effect of high-flow nasal cannula (HFNC) oxygen therapy in patients with acute respiratory failure, and investigate the indicators that predict the failure of HFNC.Methods:The clinical data of 174 patients with acute respiratory failure were retrospectively analyzed. The patients were treated with HFNC in the Emergency Department of Hunan Provincial People′s Hospital from January 2018 to September 2020. The vital signs, blood gas analysis, Borg score and ROX index of patients before and one hour after HFNC application were compared, and the application effect of HFNC was judged. The HFNC failure group was defined as patients with respiratory support upgraded to non-invasive ventilation, endotracheal intubation or death within 48 h, and the indicators for predicting the HFNC failure were analyzed.Results:The failure rate of HFNC was 24.13%(42/174). There were significant differences in the heart rate, SpO 2, systolic blood pressure, diastolic blood pressure and PaO 2 of successfal group before and after the use of HFNC, t values were -8.12-4.60, all P<0.05. Multivariate Logistic regression analysis showed that the change value of systolic blood pressure was a protective factor of the failure of HFNC ( OR=0.967, 95% CI were 0.949-0.985, P<0.05). Conclusions:The application of HFNC in patients with acute respiratory failure is feasible and effective, and the change value of systolic blood pressure is an indicator to predict the failure of HFNC.
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Objective To observe the clinical efficacy and safety of caffeine citrate combined with heated humidified high-flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) in preterm infants.Methods From June 2017 to December 2018,a total of 82 preterm infants with RDS (28 weeks ≤ gestational age＜32 weeks) who were hospitalized in Neonatal Intensive Care Unit of the Affiliated Xuzhou Hospital of Southeast University were chosen as research subjects.They were randomly (random number table method) divided into two groups:the combined treatment group (n=42) and the control group (n=40).Infants in the combined treatment group were given caffeine citrate combined with HHHFNC,while infants in the control group were given nasal continuous positive airway pressure (NCPAP) without caffeine citrate.The general clinical data,results of blood gas analysis at 6 h and 24 h after breath support therapy,clinical efficacy,related complications and adverse drug reactions between the two groups were compared statistically by LSD-t test,Chi-square test and Kruskal-Wallis H rank sum test.Results ① No significant differences were found between the two groups in the general clinical data (all P＞0.05).② The results of intra-groups comparison within the combined treatment group or control group showed that the pH value,partial pressure of arterial carbon dioxide (PaCO2),partial pressure of arterial oxygen (PaO2) of blood gas analysis and PaO2/fraction of inspired oxygen (P/F) at 6 h and 24 h after breath support therapy were all significantly improved compared to those of before treatment (all P＜0.05);The PaO2 and P/F of premature infants in the combined treatment group at 6 h and 24 h after breath support therapy were significantly higher than those in the control group,while PaCO2 were significantly lower than that in the control group (all P＜0.05).③ The duration of noninvasive ventilation,total oxygen inhaling,failure rate of machine withdrawal,use of pulmonary surfactants,the rate of tracheal intubation within 72 h and the times of apnea in combined treatment group were 3.0 d (1.0,18.0)d,5.5 d (3.0,21.0)d,4 case(9.5％),10 case(23.8％),3 case(7.1％) and 6.0 times(3.0,21.0)times,which were significant shorter,or lower,or less than those in control group,which were 7.0 d (2.0,22.0),10.0 d (4.0,28.0),11 case(27.5％),19 case(47.5％),12 case(30.0％)and 15.0 times(4.0,28.0)times,and the differences were all statistically significant (all P＜0.05).④ The occurrence of nasal trauma,abdominal distention and head shaping in the combined treatment group were significantly lower than those in the control group (all P＜0.05).⑤ There were no significant differences between the two groups of premature infants in related complication and caffeine associated adverse reactions (all P＞0.05).Conclusions Caffeine citrate combined with HHHFNC treatment strategy for premature infants with RDS can effectively improve oxygenation,shorten the duration of noninvasive mechanical ventilation,increase the success rate of machine withdrawal,and reduce the incidence of nasal trauma and abdominal distention.
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Objective To assess the clinical efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) for prevention of extubation failure in preterm infants with respiratory distress syndrome (RDS).Methods From March 2016 to December 2017,75 preterm infants (≤32 weeks gestation) with RDS who needed noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube in neonatal intensive care unit were studied.They were randomly assigned into the HHHFNC group (38 cases) and the NCPAP group (37 cases) by using a random number table.The main observation was the success rate of removal of the ventilator,duration of noninvasive ventilation time,the total oxygen inhaling time,feeding conditions and incidence of adverse events.Results The baseline demographic characteristics of the two groups were similar in terms of gestational age,birth weight,gender,incidence of cesarean delivery,premature rupture of membranes,administrations of antenatal glucocorticoid prophylaxis,Apgar scores at 1 and 5 minutes (P ＞ 0.05).No significant difference was found in the success rate of removal of the ventilator between HHHFNC group and NCPAP group(94.7 ％ vs.91.9％,P ＞ 0.05).The time of noninvasive ventilation,the total oxygen inhaling time and hospital stay in the NCPAP group were shorter than those in the HHHFNC group,but there were no significant differences between two groups (P ＞ 0.05).The occurrence of abdominal distention (10.5％ vs.27.05％),nasal trauma(5.2％ vs.21.6％),head shaping(0 vs.32.4％) were lower in HHHFNC group than those in NCPAP group (P ＜0.05).The time needed to achieve total enteral nutrition[(10.1 ± 1.2) d vs.(14.1 ± 1.6)d] and the incidence of feeding intolerance (13.1％ vs.29.7％) were reduced in HHHFNC group than those in NCPAP group (P ＜ 0.05).Conclusion As an respiratory support for the treatment of preterm infants with RDS after extubation,HHHFNC has the similar efficacy with NCPAP.However,HHHFNC has lower incidence of nasal trauma,abdominal distension and feeding intolerance,and further clinical research is needed.
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Objective To observe the effect of heated humidified high flow nasal cannula oxygen therapy (HFNC) on patients with post-stroke systemic inflammatory response syndrome (SIRS). Methods Totally 78 patients with post-stroke SIRS were selected in the department of neurology of Wuxi People's Hospital and were randomly divided into HFNC group (n=40) and conventional therapy group (n = 38). The neurological impairment score (NIHSS) , APACHE-Ⅱ, clinical pulmonary infection score (CPIS) , C-reactive protein (CRP) of the 2 groups were recorded before and after the treatment. At the same time, modified Rankin score (mRS) of the two groups were also recorded. Results There was no significant difference in terms of morality and the number of patients with mechanical ventilation in the 2 groups. The 7-day APACHE Ⅱ, 7-day CPIS, 7-day SIRS cure rate, 14-day NIHSS and mRS of 3 months in HFNC group were higher than those in the conventional therapy group (P < 0.05).There was no significant difference in 7-day CRP, 14-day CRP and 14-day CPIS between HFNC group and conventional oxygen therapy group (P> 0.05). Conclusions HFNC can improve lung infection of patients with SIRS thus improve the recovery rate of SIRS. At the same time, it can improve the recovery of the neurological deficit and prognosis in acute stroke.
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Objective@#To investigate the clinical efficacy of sequential heated humidified high flow nasal ca-nnula(HHHFNC)after extubation in premature infants with pulmonary hemorrhage.@*Methods@#A total of 52 premature infants with pulmonary hemorrhage were selected, who were randomly (by means of random number table) given nasal intermittent positive pressure ventilation(NIPPV)(27 cases) and HHHFNC (25 cases) as a sequential respiratory su-pport from January 2017 to January 2018 at Suzhou Hospital of Nanjing Medical University were selected.The incidence of the basic conditions of the 2 groups of premature infants [gestational age, birth weight, mechanical ventilation days after pulmonary hemorrhage, high-frequency ventilation, usage of nitric oxide(NO)], blood gas analysis indicators at 1 h before extubation and ventilator parameters including the arterial oxygen partial pressure [pa(O2)], arterial partial pressure of carbon dioxide [pa(CO2)], pH value, positive end-expiratory pressure(PEEP), respiratory rates (RR), peak inspiratory pressure (PIP), fraction of inspiration oxygen (FiO2) were compared.The blood gas analysis after extubation [pa(O2), pa(CO2), pH value] at 1 h, outcome events/complications at the end of treatment (reintubation, uration of oxygen therapy after pulmonary hemorrhage, hospitalization days, bronchial pulmonary hypoplasia, ventilator associated pneumonia, feeding intolerance, neonatal necrotizing enterocolitis, pneumothorax) were also compared.@*Results@#There were no significant differences between the NIPPV group and the HHHFNC group in the following items: gestational age, birth weight, mechanical ventilation days after pulmonary hemorrhage, high-frequency ventilation, usage of NO[(30.5±2.9) weeks vs.(31.6±2.7) weeks, 1 325(818) g vs.1 400(800) g, 5 days vs.4 days, 25.9%(7/27 cases) vs.24.0%(6/25 cases), 7.4%(2/27 cases)vs.0(0/25 cases), all P>0.05]. There were no significant differences between the two groups in blood gas analysis indicators before extubation at 1 h and ventilator parameters [pa(O2), pa(CO2), pH value, PEEP, RR, PIP, FiO2], blood gas analysis [pa(O2), pa(CO2), pH value] after extubation at 1 h (all P>0.05); There were no significant differences between the two groups in reintubation, hospitalization days, bronchial pulmonary hypoplasia, ventilator associated pneumonia, feeding intolerance, neonatal necrotizing enterocolitis, pneumothorax [7.4%(2/27 cases) vs.4.0%(1/25 cases), 43(29) days vs.41(22) days, 40.7%(11/27 cases ) vs.16.0%(4/25 cases), 11.1%(3/27 cases) vs.12.0%(3/25 cases), 37.0%(10/27 cases) vs.32.0%(8/25 cases), 7.4%(2/27 cases ) vs.12.0%(3/25 cases), 7.4%(2/27 cases) vs.12.0%(3/25 cases)] (all P>0.05). The duration of oxygen therapy after pulmonary hemorrhage in the HHHFNC group was shorter than that in the NIPPV group [25(30) days vs.9(22) days, P<0.05].@*Conclusions@#As a sequential respiratory support for preterm infants with pulmonary hemorrhage, HHHFNC has shorter duration of oxygen therapy after pulmonary hemorrhage than that of NIPPV, suggesting that HHHFNC is an ideal non-invasive ventilation treatment.
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Objective: To compare the efficacy and safety between humidified high flow nasal cannula (HHFNC) and noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure after extubation. Methods: Seventy-two patients with COPD complicated with type 2 respiratory failure were enrolled after extubation and were randomized into HHFNC group and NPPV group at 1: 1 ratio, with 36 patients in each group. The blood gas analysis index, respiratory rate, heart rate, mean arterial pressure, reintubation rate, incidence of tracheotomy, intensive care unit stay, incidence of adverse events and mortality were compared between the two groups before treatment and 2, 12, 24 h after treatment. Results: The pH at 24 h, partial pressure of oxygen in artery (PaO2) at 2 h and 12 h, and oxygenation index (PaO2/FiO2) at 2 h and 12 h after treatment were significantly higher in the HHFNC group compared with the NPPV group (all P0.05), while the overall incidence of adverse events, intolerance rate, flatulence rate and aspiration rate were significantly lower in the HHFNC group than those in the NPPV group (all P 0.05). Conclusion: The short-time efficacy and safety of HHFNC are better than NPPV in treatment of COPD complicated with type 2 respiratory failure.
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Various forms of noninvasive respiratory support have been applied to the treatment of infant respiratory distress and hypoxemia. The most common noninvasive respiratory support in neonatal intensive care unit is nasal continuous positive airway pressure (NCPAP). But the NCPAP systems are not always well accepted by the neonatal population, with the risk of mucosal injury and nosocomial infection. In recent years, humidified high-flow nasal cannula (HHFNC) has been introduced and developed as a possible alternative to NCPAP for noninvasive respiratory support mode, because it increases patients' comfort and the effectiveness of the ventilation. This article summarized the current research progress of HHFNC therapy in pediatric patients.
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Various forms of noninvasive respiratory support have been applied to the treatment of infant respiratory distress and hypoxemia.The most common noninvasive respiratory support in neonatal intensive care unit is nasal continuous positive airway pressure (NCPAP).But the NCPAP systems are not always well accepted by the neonatal population,with the risk of mucosal injury and nosocomial infection.In recent years,humidified high-flow nasal cannula (HHFNC) has been introduced and developed as a possible alternative to NCPAP for noninvasive respiratory support mode,because it increases patients' comfort and the effectiveness of the ventilation.This article summarized the current research progress of HHFNC therapy in pediatric patients.
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Objective To evaluate the clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation intensive care unit(ICU)patients. Methods A computerized search was performed through Cochrane Library,EMBASE,PubMed,Elsevier,CNKI,Wanfang Database, SinoMed for randomized controlled trial(RCTs) which studied the effects of clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation ICU patients. Two reviewers separately searched the articles, evaluated the quality of the literatures, extracted date according to the inclusion and exclusion criteria. RevMan5.3 was used for Meta-analysis. Results Five RCTs were included involving 982 patients in the study. The Results of meta-analysis showed that the HFNC group was lower than COT group on the re-intubation rate (OR=0.39, 95% CI 0.25-0.62, P<0.05). About oxygenation index, comfort level and toleration of patients, HFNC group was superior to the COT group. Two groups had no significant differences(P>0.05)on post-extubation respiratory failure(OR=0.85,95% CI 0.35-2.09),respiratory infection(OR=0.69,95% CI 0.36-1.34),hospital length of stay(MD=0.51,95%CI-0.02-1.03), mortality of hospital (OR=0.81,95% CI 0.39-1.69). Conclusions The use of HFNC oxygen therapy can reduce there-intubation rate,improve oxygenation index,comfort level and tolerance on post-extubation ICU patients, while HFNC group has no significant impact on the post-extubation respiratory failure, respiratory infection, hospital length of stay, mortality of hospital compared with COTgroup. However, in view of the quantity and quality of study. More RCTs should be conducted to verify the results.
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Objective To explore the clinical value of humidified high flow nasal cannula oxygen therapy (HHFNC) oxygen therapy for acute hypoxic respiratory failure.Methods Totally 37 patients with acute hypoxic respiratory failure were enrolled who entered ICU from January 2016 to June 2016 and randomly divided into FM group (n=l8) and HHFNC group (n=19).The values of blood gas analysis were recorded as before treatment,1 h and 5 h after therapy,respectively.Results 1 h and 5 h after therapy,both groups had significant increase in pa(O2) compared to before treatment (P＜0.05).Meanwhile,HHFNC group had higher level ofpa(O2) in comparison to FM group (P＜0.05).Conclusion HHFNC oxygen therapy has a therapeutic effect on acute hypoxic respiratory failure which helps to correct hypoxemia and improve subject feeling of comfort.
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Objective To explore the clinical value of humidified high flow nasal cannula oxygen therapy (HHFNC) oxygen therapy for acute hypoxic respiratory failure.Methods Totally 37 patients with acute hypoxic respiratory failure were enrolled who entered ICU from January 2016 to June 2016 and randomly divided into FM group (n=l8) and HHFNC group (n=19).The values of blood gas analysis were recorded as before treatment,1 h and 5 h after therapy,respectively.Results 1 h and 5 h after therapy,both groups had significant increase in pa(O2) compared to before treatment (P＜0.05).Meanwhile,HHFNC group had higher level ofpa(O2) in comparison to FM group (P＜0.05).Conclusion HHFNC oxygen therapy has a therapeutic effect on acute hypoxic respiratory failure which helps to correct hypoxemia and improve subject feeling of comfort.
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Objective To study the clinical application value of humidified high flow nasal cannula(HHFNC) on bronchitis in children.Methods Total 85 cases of bronchitis that needed oxygen therapy in our department from Oct 2015 to Feb 2016 were randomly divided into three groups,HHFNC group,NCPAP group and nasal cannula oxygen group(control group).According to the blood gas results,FiO2 was adjusted to maintain PaO2 in 50~70mmHg(1mmHg=0.133kPa),TcSO2 90% to 95%.The main symptoms and signs(wheezing,shortness of breath,three depression sign,wheezing rale) disappeared time,length of oxygen inhalation and stay,the change of PaO2,PaCO2,respiratory rate were compared among the three groups.Results Compared with control group,the clinical symptoms and signs disappeared time and length of oxygen inhalation and stay were significantly shorter in HHFNC group(P0.05).Conclusion HHFNC can significantly improve the clinical symptoms,signs and blood gas results in children with bronchitis,reduce the length of oxygen inhalation and stay.HHFNC is an effective and well-tolerated treatment for bronchitis in children.
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Heated humidified high-flow nasal cannula(HHFNC) is a relatively new noinvasive method for respiratory support,initially used in premature infant apnea.In recent years,the development of HHFNC applications is rapid,and HHFNC is gradually used in older infants and children.Compared to other noninvasive oxygen supply devices,HHFNC can be used effectively in clinic because of its high comfort,good tolerance,easy care,and reducing the rate of endotracheal intubation.
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Objective To investigate the effect of humidified high flow nasal cannula (HHFNC) on severe apnea in preterm infants.Methods Eighty-two preterm infants who developed apnea more than twice in short time,recurred within 6 hours or needed mask respirator were divided into HHFNC group(n =40) and nasal continuous positive airway pressure(NCPAP) group (n =42).Both groups were given aminophylline intravenously.The total therapeutic effect rate,the number of cases who needed mechanical ventilation during the observation period,the duration of non-invasive ventilation,the duration of oxygen therapy,the oxygen exchange indexes and the complications of two groups were observed.Results There were no significant differences between two groups in the therapeutic effect rate,the number of cases who need invasive ventilation,the duration of non-invasive ventilation time,oxygen exchange indexes and the duration of oxygen usage (P ＞ 0.05).The numbers of nose injury of HHFNC group were less than those of the NCPAP group [10.0％ (4/40) vs.30.9％ (13/42)] (P ＜0.05).No significant differences were found between two groups in the complication of necrotizing enterocolitis or feeding intolerance,respiratory infection,retinopathy of prematurity,bronchopulmonary dysplasia (P ＜ 0.05).Conclusion HHFNC has the same effect as NCPAP in the treatment of severe apnea in preterm infants except for lower prevalence of nose injury.
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Objective To explore the effect of humidified high flow nasal cannula (HHFNC) in neonatal with severe pneumonia.Methods Forty-two cases of neonatal with severe pneumonia according to different treatment methods were divided into treatment group (20 cases) and control group (22 cases).Treatment group was given HHFNC,control group was given the wet bottle oxygen nasal cannula or mask.Disappearance of symptoms and hospital stay in two groups,blood oxygen saturation (SpO2),partial pressure of oxygen (PaO2),partial pressure of earbondioxidc (PaCO2) and respiratory rate in treatment group before and after the application of HHFNC were compared.Results The effective rate in treatment group was significantly higher than that in control group [90.00％ (18/20) vs.63.64％ (14/22)],which reached statistical significance (P ＜0.05).Disappearance of symptoms and hospital stay in treatment group were shorter than those in control group,and mechanical ventilation rate was lower than that in control group [10.00％(2/20) vs.45.45％(10/22)],which reached statistical significance (P ＜ 0.05).SpO2 and PaO2 at application of HHFNC after 12,24 h and 1 h after evacuation of HHFNC were significantly increased eompared with those before [0.921 ± 0.027,0.955 ± 0.021,0.958 ± 0.016 vs.0.865 ± 0.045; (83.4 ± 28.3),(89.8 ±20.4),(92.8 ±12.6) mmHg (1 mmHg =0.133 kPa) vs.(52.8 ±10.1) mmHg],PaCO2 at application of HHFNC after 24 h and 1 h after evacuation of HHFNC were significantly reduced compared with those before [(46.1 ±6.3),(43.7 ±7.2) mmHg vs.(59.7 ± 8.3) mmHg],which reached statistical significance (P ＜0.05).Respiratory rate was decreased with the treatment time,which reached statistical significance (P＜ 0.05).Conclusion Application of HHFNC in neonatal with severe pneumonia is effective and woorth promoting.
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Objective To compare the efficacy and safety of caffeine combined with humidified high-flow nasal cannula(HHHFNC) and nasal continuous positive airway pressure(nCPAP) on the treatment of apnea in very low birth weight (VLBW) preterm infants.Methods Totally 80 VLBW preterm infants with neonatal apnea,who were enrolled in the NICU of Hebei Province Children Hospital from September 2013 to March 2014,were randomly assigned to either HHHFNC group(39 cases) or nCPAP group(41 cases) according to respiratory support mode by random number table method,both groups were given caffeine.The incidence of severe apnea,incidence of reintubation,oxygen exposure time,duration of non-invasive ventilation time,feeding conditions and incidence of adverse events were compared.Results There were no significant differences in male/female ratio,gestational age,age at randomization and birth weight between the two groups(P ＞0.05).There were no significant differences in the incidence of severe apnea[15.4％ (6/39) vs 12.2 ％ (5/41)],incidence of reintubation [17.9 ％ (7/39) vs 19.5 ％ (8/41)],oxygen exposure time [(183.1 ± 31.2) h vs (175.9 ± 32.1) h],duration of non-invasive ventilation time [(163.3 ± 25.1) h v s (153.0 ± 26.2) h] between the two groups (P ＞ 0.05).The occurrence of abdominal distention [7.7 ％ (3/39) vs 24.4％ (10/41)],nasal trauma[2.6％ (1/39) vs 19.5 ％ (8/41)],head shaping [0.0％ (0/39)vs 29.3％ (12/41)] during treatment were lower in HHHFNC group than those of nCPAP group (P ＜ 0.05).Age began feeding was earlier in HHHFNC group than nCPAP group [(67.5 ± 19.1) h vs (96.3 ± 18.7) h,P ＜ 0.05],and day to full oral feeding was reduced in HHHFNC group than nCPAP group [(346.8±28.6) h vs (371.0 ±29.4),P ＜0.05].Conclusion HHHFNC combined with caffeine is effective on the treatment of apnea in VLBW preterm infants,and easier to make newborn tolerated.HHHFNC is an effective non-invasive respiratory support mode with few side effects.
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PURPOSE: The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants. METHODS: A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth. RESULTS: Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2+/-16.7 vs. 24.7+/-10.2, P=0.05) and regain birth weight (20.9+/-16.9 vs. 17.2+/-4.3, P=0.04) decreased in the HHFNC group. CONCLUSION: HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.