Aims Infants born extremely prematurely and who develop bronchopulmonary dysplasia (BPD) may require respiratory support for many months, including when they could be able to take oral feeds (usually 34 weeks postmenstrual age (PMA)). Our aim was to test the hypothesis that full oral feeding in infants with BPD would be achieved earlier in those supported by humidified high flow nasal cannula (HHFNC) rather than nCPAP.
Methods Data were compared from infants born prior to 33 weeks of gestational age between 2011 to 2013, who were extubated onto and supported by nCPAP until they required only low flow oxygen (nCPAP group) to those born between 2013 to 2015 who were extubated onto nCPAP and then transferred to HHFNC if they continued to require nCPAP for more than two weeks and had a supplementary oxygen requirement of less than 40% (nCPAP/HHFNC group).
Results There were 72 infants in the nCPAP group and 44 infants in the nCPAP/HHFNC group.
There were no significant differences with regard to gestational age or birth weight between the two groups. The PMA at trial of first oral feeds was lower (p = 0.015) and the weight at 36 weeks of gestational age (p = 0.001) was higher in the nCPAP/HHFNC group. The length of time spent on CPAP and HHFNC was longer than compared to CPAP alone in the nCPAP group (p = 0.003), but the duration of low flow oxygen was lower in the nCPAP/HHFNC group (p = 0.035). A subgroup analysis was performed of infants requiring non-invasive respiratory support after 34 weeks PMA (27 infants nCPAP group and 33 infants nCPAP/HHFNC group). The PMA at trial of first (p < 0.001) and full oral (p < 0.001) feeds was earlier in the nCPAP/HHFNC group. The duration of low flow supplementary oxygen (p = 0.002) and total length of hospital stay (p = 0.003) were lower in the nCPAP/HHFNC group.
Conclusion In infants with BPD who required respiratory support beyond 34 weeks PMA, use of nCPAP then HHFNC was associated in earlier establishment of full oral feeds and a shorter length of stay.
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