Background Neonatal respiratory support using high flows of heated/humidified gas via nasal cannulae has gained acceptance in the UK despite limited evidence of efficacy and safety. HHFNC seems well tolerated with little reported airway trauma, reduced noise exposure, and easier nursing than NCPAP.
Aim To determine current practices in terms of usage, types of devices and weaning regimes of HHFNC.
Methods All 203 neonatal units across UK were contacted and a structured telephone questionnaire completed.
Results All 203 UK neonatal units (100%) completed the survey, 113 neonatal units (56%) use some form of HHFNC. There is more HHFNC use in level 3 neonatal intensive care units (Table 1).
Of the units using HHFNC, 47 (42%) use HHFNC either as standard respiratory support following extubation or following NCPAP with the remainder (58%) using NCPAP initially and then HHFNC. The majority (60%) of units commenced HHFNC at 8 litres per minute (lpm) flow and 30% of units at 5–6lpm and reduced in 0.5–1lpm steps to wean. Most units weaned off HHFNC once the flow rate was 2–3lpm.
Conclusion This is a large UK study evaluating the use of HHFNC. This survey demonstrates increasing use of HHFNC and wide variations in methods of use and weaning parameters. There is a need for further research in this area.