Changes in Lung mechanics with High-Flow Nasal Cannula compared to nasal CPAP in Preterm Infants

Abstract Objective: To compare the degree of atelectasis in preterm infants on nasal continuous airway pressure (nCPAP) versus high-flow nasal cannula (HFNC) at 8 L/min. Study Design: A cross-over study of preterm infants <29 weeks gestational age (GA) receiving nCPAP and underwent 6-hours of HFNC at 8 L/min before returning to nCPAP. Electrical Impedance Tomography (EIT) was used to measure lung mechanics in dependent silent spaces (DSS), end-expiratory lung volume (EELV), ventral/dorsal center of ventilation (CoV-VD), and relative tidal stretch. Results: 80 infants were recruited. There were no differences in estimated marginal mean measurements of DSS (p=0.76), EELV (p=0.68), CoV-VD (p=0.05), and relative tidal stretch (p=0.42) between respiratory support modes. Conclusion: This study of premature infants <29 weeks GA at birth demonstrated no significant difference in DSS. EIT was able to detect real-time changes in the distribution of ventilation which may allow clinicians to identify infants at substantial risk to failure. ClinicalTrials.gov ID: NCT03700606