HFNC and NCPAP in Extremely Preterm Infants

Comparisons of the Dynamic of the Cardiorespiratory System Behavior of Extreme Preterm Infants Receiving Nasal CPAP or High Flow Nasal Cannula During the Immediate Post-extubation Period

To avoid or decrease the rate of complications in preterm infants after disconnection from a mechanical ventilation (extubation), non-invasive respiratory support is routinely used. While infants are most commonly extubated to nasal continuous positive airway pressure (NCPAP), high flow nasal cannula (HFNC) has emerged as an attractive alternative. However, research regarding the safety and efficacy of HFNC in the most extreme preterm infants is limited. Therefore, we hypothesize that immediately after extubation, measures of heart rate and respiratory behavior may be useful to investigate for any differences between HFNC and NCPAP.

Infants will be studied 30 min after extubation on both modes of support, provided in a random order. A transition period of 15 min between modes will be given. For each mode, recordings will be performed for 40 minutes. Analysis of these recordings will be done off line.

Inclusion Criteria:

• Infants with birth weight ≤ 1250 grams
• Infants that have been mechanically ventilated and undergoing their first elective extubation attempt

Exclusion Criteria:

• Major congenital anomalies, neuromuscular disease, hemodynamic instability (use of vasopressors or hypotension).
• Infants reintubated before initiation or during data collection.
• Parental/legal guardian consent not obtained.