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Flojo nasa meaning1/2/2024 ![]() 3 - 5 In contrast to nCPAP, for which the rationale is essentially based on the provision of a continuous distending pressure, multiple mechanisms have been suggested to explain HHHFNC functioning, such as washout of the nasopharyngeal dead space, optimal gas conditioning, and provision of a variable distending pressure. 1, 2 In recent years, heated, humidified high-flow nasal cannula (HHHFNC) has increased in popularity in high-resource countries as an alternative form of noninvasive respiratory support for newborn infants. Owing to its potential of reducing lung injury associated with mechanical ventilation, the use of noninvasive respiratory support, particularly nasal continuous positive airway pressure (nCPAP), has become a common strategy for early respiratory management of preterm infants. Trial Registration Identifier: NCT02570217 Significant between-group differences in secondary outcomes were not found between the HHHFNC and nCPAP/BiPAP groups, including duration of respiratory support (median, 4.0 vs 4.0 days 95% CI of difference in medians, −1.0 to 0.5 P = .45), need for surfactant (44.3% vs 46.2% 95% CI of risk difference, −9.8 to 13.5 P = .73), air leaks (1.9% vs 2.5% 95% CI of risk difference, −3.3 to 4.5 P = .70), and bronchopulmonary dysplasia (4.4% vs 5.1% 95% CI of risk difference, −3.9 to 7.2 P = .79).Ĭonclusions and Relevance In this study, HHHFNC showed efficacy and safety similar to those of nCPAP/BiPAP when applied as a primary approach to mild to moderate RDS in preterm infants older than 28 weeks’ GA. The use of HHHFNC was noninferior to nCPAP with regard to the primary outcome: failure occurred in 10.8% vs 9.5% of infants, respectively (95% CI of risk difference, −6.0% to 8.6% P = .71). ![]() Results A total of 316 infants were enrolled in the study: 158 in the HHHFNC group (mean GA, 33.1 weeks 52.5% female) and 158 in the nCPAP/BiPAP group (mean GA, 33.0 weeks 47.5% female). An intention-to-treat analysis was performed. The absolute risk difference in the primary outcome and its 95% confidence interval were calculated to determine noninferiority (noninferiority margin, 10%). Main Outcomes and Measures Need for mechanical ventilation within 72 hours from the beginning of respiratory support. Interventions Randomization to either HHHFNC at 4 to 6 L/min or nCPAP/BiPAP at 4 to 6 cm H 2O. Infants were enrolled between January 5, 2012, and June 28, 2014. Infants were ineligible if they had major congenital anomalies or severe RDS requiring early intubation. Criteria for starting noninvasive respiratory support were a Silverman score of 5 or higher or a fraction of inspired oxygen higher than 0.3 for a target saturation of peripheral oxygen of 88% to 93%. Inborn infants at 29 weeks 0 days to 36 weeks 6 days of GA were eligible if presenting with mild to moderate RDS requiring noninvasive respiratory support. Objective To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks’ gestational age (GA).ĭesign, Setting, and Participants An unblinded, monocentric, randomized clinical noninferiority trial at a tertiary neonatal intensive care unit. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Importance Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. ![]()
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