Affiliations: Neonatal Intensive Care Unit, Children's and Women's
Health Centre of British Columbia, University of British Columbia, Vancouver, Canada
Note: [] Corresponding author: Horacio Osiovich, MD, Neonatal Intensive
Care Unit, BC's Children's Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4.
E-mail: [email protected]
Abstract: Background: In the recent years, a new treatment modality, high-flow
nasal cannulae (HFNC) has become widely used despite limited systematic
evaluation. Objective: To survey the attitudes and practices in academic
neonatal units in the United States regarding the use of HFNC and to review the
current literature on HFNC. Methods: A questionnaire regarding HFNC use
was distributed to all (n=97) Neonatal-Perinatal Medicine Fellowship
Training Program Directors in the United States. Results: Fifty eight
(60%) program directors responded to the questionnaire. Of these 40 (69%)
reported using heated humidified HFNC (HHHFNC) and 18 (31%) not using this
modality. Reported starting flows ranged from 1 to 6 L/min and maximal flows
from 2 to 8 L/min. The indication for use of HHHFNC varied between units. Conclusions: The findings of our survey and our review of the literature
suggest that the use of HHHFNC is widespread despite lack of evidence of
efficacy from large clinical trials. The indications for HHHFNC and the
initial, minimal and maximal flows varied widely among the centers. This report
supports the need for well designed randomized controlled clinical trials to
evaluate the efficacy and safety of HHHFNC for a variety of clinical
indications.
