Division of Neonatology, Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, San Diego, CA, USA.
Division of Neonatology, Department of Paediatrics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
J Matern Fetal Neonatal Med. 2022 Mar;35(5):951-957. doi: 10.1080/14767058.2020.1735339. Epub 2020 Mar 5.
To assess the feasibility of conducting a study comparing nasal continuous positive airway pressure (nCPAP) or heated, humidified, high flow nasal cannula (HHHFNC) on oral feeding in preterm infants.
Randomized controlled pilot study in a level III NICU, of infants' born ≤28°weeks who at 34°weeks post menstrual age (PMA) were dependent on noninvasive ventilation (NIV). Infants were randomized evenly to nCPAP or HHHFNC groups and orally fed on low-flow oxygen. The primary outcomes of enrollment and retention were assessed.
We enrolled 40 infants and 12 completed the study in the nCPAP group versus 13 in the HHHFNC group. Using our respiratory and feeding protocols, we showed overall enrollment and retention rates (95%CI) at 0.66 (0.54, 0.77) and 0.63 (0.48, 0.78), respectively. Breastfeeding rates were 82% in the nCPAP group and 76% in the HHHFNC group. Infants in the HHHFNC group reached full feeds 7 days earlier than those in the nCPAP group.
Based on our retention rate, an adequately powered randomized controlled trial can be performed to confirm or refute that HHHFNC is associated with achieving oral feeds earlier.
United States National Library of Medicine (www.clinicaltrials.gov) Identifier: NCT02055339. First posted 2/5/2014.
评估比较经鼻持续气道正压通气（nCPAP）或加热、湿化、高流量鼻导管（HHHFNC）对早产儿经口喂养的可行性。
在三级 NICU 中进行的随机对照试验，研究对象为出生胎龄≤28 周且在 34 周月经龄（PMA）时依赖无创通气（NIV）的婴儿。婴儿随机平均分为 nCPAP 组或 HHHFNC 组，在低流量氧气下经口喂养。评估了入组和保留的主要结果。
我们共纳入了 40 名婴儿，其中 nCPAP 组有 12 名婴儿完成了研究，而 HHHFNC 组有 13 名婴儿完成了研究。使用我们的呼吸和喂养方案，我们得出了总的入组和保留率（95%CI）分别为 0.66（0.54，0.77）和 0.63（0.48，0.78）。nCPAP 组母乳喂养率为 82%，HHHFNC 组为 76%。HHHFNC 组的婴儿比 nCPAP 组更早达到全量喂养。
基于我们的保留率，可以进行一项足够有力的随机对照试验，以确认或反驳 HHHFNC 与更早实现经口喂养相关。
美国国立医学图书馆（www.clinicaltrials.gov）标识符：NCT02055339。首次发布日期为 2014 年 2 月 5 日。
