Prematurity, Mechanical Ventilation Clinical Trial
Official title:
HHHFNC to Prevent Extubation Failure in Preterm Infants: A Randomized Controlled Trial
This is a randomized controlled trial (RCT) to evaluate the influence of two flow rates (6 liter/min versus 3 liter/min) of Heated-Humidified High-Flow-Nasal-Cannula (HHHFNC) on rates of extubation failure in mechanically ventilated preterm infants.
HHHFNC has been proposed as an alternative to nasal continuous positive airway pressure
(nCPAP) in neonatal intensive care units (NICUs) for preventing extubation failure. In a
recent international survey on periextubation practices in extremely preterm infants, nCPAP
was the most common type of respiratory support used (84%) followed by nasal intermittent
positive pressure ventilation (55%) and HHHFNC (33%). Moreover, HHHFNC appears to have
efficacy and safety similar to those of nCPAP when applied immediately post-extubation to
prevent extubation failure in preterm infants. and resulted in significantly less nasal
trauma in the first 7 days post-extubation than nCPAP. However, the best flow rates of HHHFNC
to prevent extubation failure remains to be known.
This RCT aims to compare the efficacy and safety of postextubation respiratory support via
HHHFNC at two different flow rates (6 L/min. versus 3 L/min) regarding successful extubation
after a period of endotracheal positive pressure ventilation. We hypothesized that
postextubation respiratory support via HHHFNC at a flow rate of 6 L/min. will result in a
greater proportion of preterm infants being successfully extubated after a period of
endotracheal positive pressure ventilation compared with HHHFNC at a flow rate of 3 L/min.
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