An observational longitudinal study of the use of
            ROX
            index to predict treatment failure in patients receiving continuous positive airway pressure for
            COVID
            ‐19

Objective: To determine the efficacy of nasal continuous positive airway pressure (NCPAP) versus heated humidified high-flow nasal cannula (HHHFNC) as a primary mode of respiratory support in preterm infants with respiratory distress. Methodology: This randomized controlled trial study was conducted at in-patient department of neonatology (Nursery & NICU) of Pakistan Insitute of Medical Sciences (PIMS) from July 2020 to Dec 2020. A total of 280 neonates randomly divided (140 in each study group) of both genders, with gestational age between 28-34 weeks and having mild-to-moderate respiratory distress within 1st 6 hours of birth requiring non-invasive ventilation were enrolled. Neonates in NCPAP Group (n=140) were given NCPAP whereas neonates in HHHFNC Group (n=140) were given HHHFNC. The efficacy of both groups were compared on the basis of treatment failure within 1st 3 days, total duration (hours) of non-invasive ventilator (NIV) required and total duration (hours) of supplementary oxygen required. Results: Overall, mean gestational age was noted to be 30.0+6.4 weeks. There were 144 (51.4%) neonates with birth weight between 1 to 1.4 kg, 90 (32.1%) between 1.5 to 1.9 kg and 46 (16.4%0 between 2.0 to 2.4 kg. Treatment failure was noted in 67 (47.6%) neonates in NCAP group while HHHFNC group reported 73 (52.4%) neonates with treatment failure (p=0.4733). No significant difference was observed in mean total duration of NIV support required (p=0.2598) or mean total duration of supplementary oxygen (p=0.1946) in between study groups. Conclusion: HHHFNC had similar efficacy when compared to NCPAP among neonates with RDS. In comparison to NCPAP, HHHFNC could be a simple, well-tolerated and effective alternative in terms of respiratory support. No major difference in terms of complication was observed between both treatment approaches.

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High-Flow Nasal Cannula versus Continuous Positive Airway Pressure in Critical Bronchiolitis: A Randomized Controlled Pilot

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1709656 ◽

2020 ◽

Vol 09 (04) ◽

pp. 248-255

Author(s):

Regina Grigolli Cesar ◽

Bibiane Ramos Pinheiro Bispo ◽

Priscilla Helena Costa Alves Felix ◽

Maria Carolina Caparica Modolo ◽

Andreia Aparecida Freitas Souza ◽

...

Keyword(s):

Pilot Study ◽

Continuous Positive Airway Pressure ◽

Treatment Failure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

High Flow ◽

Nasal Cannula ◽

Positive Pressure ◽

High Flow Nasal Cannula ◽

Randomized Controlled

AbstractWe conducted a randomized controlled pilot study in infants with critical bronchiolitis (n = 63) comparing high-flow nasal cannula (HFNC, n = 35) to continuous positive airway pressure (CPAP, n = 28). The primary outcome was treatment failure, defined as the need for bilevel positive pressure ventilation or endotracheal intubation. Treatment failure occurred in 10 patients (35.7%) in the CPAP group and 13 patients (37.1%) in the HFNC group (p = 0.88). Pediatric intensive care unit length of stay was similar between the CPAP and HFNC groups (5 [4–7] days and 5 [4–8] days, p = 0.46, respectively). In this pilot study, treatment with HFNC resulted in a rate of treatment failure similar to CPAP.

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Factors influencing compliance to continuous positive airway pressure treatment in obstructive sleep apnea and mortality associated with treatment failure

Sleep Medicine ◽

10.1016/j.sleep.2017.11.730 ◽

2017 ◽

Vol 40 ◽

pp. e250

Author(s):

A. Palm ◽

B. Midgren ◽

J. Theorell-Haglöw ◽

C. Janson ◽

E. Lindberg

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Treatment Failure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Pressure Treatment ◽

Factors Influencing ◽

Obstructive Sleep

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Systematic review of high-flow nasal cannula versus continuous positive airway pressure for primary support in preterm infants

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-321094 ◽

2021 ◽

pp. fetalneonatal-2020-321094

Author(s):

Shaam Bruet ◽

Marine Butin ◽

Frederic Dutheil

Keyword(s):

Continuous Positive Airway Pressure ◽

Treatment Failure ◽

Preterm Infants ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Meta Analysis ◽

High Flow ◽

Respiratory Support ◽

High Flow Nasal Cannula ◽

Nasal Trauma

IntroductionWe conducted a meta-analysis of trials that compared efficacy and safety of high-flow nasal cannula (HFNC) with continuous positive airway pressure (CPAP) as primary respiratory support in preterm infants and a study of the impact of clinical relevant parameters.MethodsDatabases were searched for randomised controlled trials comparing HFNC with CPAP as primary respiratory support in preterm infants. Treatment failure was considered as primary outcome and adverse events as secondary outcomes. We calculated risk ratios (RRs) in intention-to-treat analysis and random-effects meta-analyses of risks were conducted.ResultsWe included 10 studies for a total of 1830 patients. Meta-analysis demonstrated an RR of treatment failure multiplied by 1.34 using HFNC compared with CPAP (RR=1.34, 95% CI 1.01 to 1.68, I2=16.2%). Secondary outcome meta-analysis showed no difference in intubation rates (RR=0.90, 95% CI 0.66 to 1.15) and a lower rate of nasal trauma using HFNC compared with CPAP (RR=0.48, 95% CI 0.31 to 0.65, I²=0.0%). Meta-regressions did not show any influence of gestational age and weight at birth, HFNC flow rate, type of CPAP generator or use of surfactant.ConclusionsDespite a higher risk of treatment failure, considering no difference in intubation rates and a lower rate of nasal trauma using HFNC compared with CPAP, we suggest that HFNC should be used as primary respiratory support in preterm infants.

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Continuous Positive Airway Pressure (CPAP) Therapy for the Treatment of Hypernasality: A Single Case Study

Perspectives on Speech Science and Orofacial Disorders ◽

10.1044/ssod24.2.48 ◽

2014 ◽

Vol 24 (2) ◽

pp. 48-58 ◽

Cited By ~ 3

Author(s):

Lakshmi Kollara ◽

Graham Schenck ◽

Jamie Perry

Keyword(s):

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Single Case ◽

Treatment Method ◽

Post Treatment ◽

Subjective Perception ◽

Cpap Therapy ◽

Long Term Follow Up

Studies have investigated the applications of Continuous Positive Airway Pressure (CPAP) therapy in the treatment of hypernasality due to velopharyngeal dysfunction (VPD; Cahill et al., 2004; Kuehn, 1991; Kuehn, Moon, & Folkins, 1993; Kuehn et al., 2002). The purpose of this study was to examine the effectiveness of CPAP therapy to reduce hypernasality in a female subject, post-traumatic brain injury (TBI) and pharyngeal flap, who presented with signs of VPD including persistent hypernasality. Improvements in mean velopharyngeal orifice size, subjective perception of hypernasality, and overall intelligibility were observed from the baseline to 8-week post-treatment assessment intervals. Additional long-term assessments completed at 2, 3, and 4 months post-treatment indicated decreases in immediate post-treatment improvements. Results from the present study suggest that CPAP is a safe, non-invasive, and relatively conservative treatment method for reduction of hypernasality in selected patients with TBI. More stringent long-term follow up may indicate the need for repeated CPAP treatment to maintain results.

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