Introduction Noninvasive ventilation with nasal CPAP (n-CPAP), or nasalintermittant positive pressure ventilation (n-IPPV) is becoming standard ofcare in preterm. Limited experience has been reported withnasal high frequency oscillatory ventilation (n-HFOV). We present 2 newbornstreated by n-HFOV applied with binasal prongs (Ram cannula Neotech) and DraegerBabylog 8000+ ventilator.

Cases 1. A 900 gr. 28 weeks gestation infant was intubated, given surfactant and ventilated by volume guarantee pressure-support ventilation for RDS. On 2nd day HFOV was started due to worsening respiratory status. On 11th day patient was extubated to n-HFOV and continued for 4 days followed by n-IPPV/n-CPAP.

2. A 830 gr. 28 weeks gestation infant was resuscitated in the delivery room. RDS and pulmonary interstitial emphysema was detected on radiography and surfactant was given. At 12 h pneumothorax occurred necessitating thoracal tube insertion and HFOV. Conventional ventilation was tried several times without success. HFOV continued for 46 days then baby was extubated to n-HFOV. Patient required reintubation after 4 days due to sepsis.

Conclusion n-HFOV with binasal prongs could be an alternative for preterms after prolonged HFOV.