Ho Fong-Cheng, Lin Chia-Ying, Chang Ane-Shu, Yeh Ching-Yi, Chen Hsiu-Lin
Division of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Department of Pediatrics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan.
Children (Basel). 2024 Aug 15;11(8):995. doi: 10.3390/children11080995.
Heated humidified high-flow nasal cannulas (HHHFNCs) are increasingly used as an alternative strategy for weaning from nasal continuous positive airway pressure (NCPAP) in premature infants. However, the optimal pressure provided by HHHFNCs is unknown. This retrospective study investigated the pressure changes and associated factors during HHHFNC therapy in preterm infants.
Clinically stable preterm neonates born with a birth weight of 2500 g or less and receiving HHHFNC therapy for weaning from NCPAP were enrolled. The flow of the HHHNFCs was adjusted to achieve an initial pressure equivalent to the positive expiratory pressure (PEEP) of NCPAP. Subsequent pressure changes in the HHHFNCs were measured by a GiO digital pressure gauge.
Nine premature infants were enrolled. Their gestational age (mean ± SD) was 28.33 ± 2.61 weeks, and the birth weight was 1102.00 ± 327.53 g. Overall, 437 pressure measurements were conducted. The median pressure of the HHHFNCs was 5 cmHO. The generated pressure had a significant association with the body weight, postmenstrual age (PMA) and flow rate. A multiple regression model revealed that the measured pressure (cmHO) = -5.769 + 1.021 × flow rate (L/min) - 0.797 × body weight (kg) + 0.035 × PMA (days) (r = 0.37, < 0.001).
The pressure provided by HHHFNCs is influenced by body weight, PMA, and flow rate. It is feasible to set the delivered pressure of HHHFNCs to match the applied PEEP of NCPAP initially, facilitating the weaning of preterm infants from NCPAP to HHHFNCs.
加热湿化高流量鼻导管（HHHFNC）越来越多地被用作早产儿从鼻持续气道正压通气（NCPAP）撤机的替代策略。然而，HHHFNC提供的最佳压力尚不清楚。这项回顾性研究调查了早产儿接受HHHFNC治疗期间的压力变化及相关因素。
纳入出生体重2500g及以下、临床稳定且因从NCPAP撤机而接受HHHFNC治疗的早产新生儿。调整HHHFNC的流量，使其初始压力相当于NCPAP的呼气末正压（PEEP）。随后用GiO数字压力计测量HHHFNC的压力变化。
纳入9例早产儿。其胎龄（均值±标准差）为28.33±2.61周,出生体重为1102.00±327.53g。总共进行了437次压力测量。HHHFNC的中位压力为5cmH₂O。所产生的压力与体重、月经后年龄（PMA）和流速显著相关。多元回归模型显示，测量压力（cmH₂O）=-5.769+1.021×流速（L/分钟）-0.797×体重（kg）+0.035×PMA（天）（r=0.37，P<0.001）。
HHHFNC提供的压力受体重、PMA和流速影响。最初将HHHFNC的输送压力设置为与NCPAP应用的PEEP相匹配是可行的，这有助于早产儿从NCPAP撤机至HHHFNC。
