Academic Division of Child Health, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Acta Paediatr. 2013 Mar;102(3):249-53. doi: 10.1111/apa.12090. Epub 2012 Dec 11.
Heated humidified high-flow nasal cannula (HHHFNC) oxygen is a relatively new form of respiratory support and is increasing in popularity despite lack of supportive evidence and amid safety concerns. We investigated the prevalence of its use in tertiary neonatal units in the UK.
Electronic survey.
A total of 57 units were contacted and replies received from 44 (77%). HHHFNC was used in 34/44 (77%) units. Vapotherm 2000i and Fisher and Paykel RT329 were the most popular devices. 39% units used HHHFNC without policies. Most reported use in infants of any gestation (24/34, 71%) and weight (26/34, 77%) and for a variety of indications including as an alternative to CPAP (26/34, 77%), weaning off CPAP (24/34, 71%) and postextubation (18/34, 53%). The flow rates, cannula size and mouth position varied widely. The popularity of HHHFNC appeared to be its perceived ease of use and improved access to the baby.
This survey demonstrates that HHHFNC is a widely used modality in UK neonatal units. Its current use appears to be without clear criteria and mostly based on individual preference. In view of doubts about its efficacy and concerns regarding safety, this study highlights the urgent need for research to evaluate its use in newborns.
加热湿化高流量鼻导管（HHHFNC）给氧是一种相对较新的呼吸支持方式，尽管缺乏支持证据且存在安全问题，但它的使用越来越普及。我们调查了英国三级新生儿单位使用 HHHFNC 的情况。
电子调查。
共联系了 57 个单位，收到了 44 个（77%）单位的回复。HHHFNC 在 34/44（77%）个单位中使用。Vapotherm 2000i 和 Fisher 和 Paykel RT329 是最受欢迎的设备。39%的单位在没有政策的情况下使用 HHHFNC。大多数单位报告在任何胎龄（24/34，71%）和体重（26/34，77%）的婴儿中使用 HHHFNC，并且用于各种适应症，包括替代 CPAP（26/34，77%）、CPAP 脱机（24/34，71%）和拔管后（18/34，53%）。流速、导管尺寸和口腔位置差异很大。HHHFNC 的普及似乎是因为其易于使用和改善了对婴儿的接触。
本调查表明，HHHFNC 在英国新生儿单位中广泛使用。其目前的使用似乎没有明确的标准，主要基于个人偏好。鉴于对其疗效的怀疑和对安全性的担忧，本研究强调了迫切需要研究评估其在新生儿中的应用。
