Nasal high flow therapy in infants with bronchiolits: PARIS trial (Paediatric Acute Respiratory Intervention Studies)

2019 ◽  
Author(s):  
Donna Franklin
Keyword(s):  
Intervention Studies ◽  
High Flow ◽  
Nasal High Flow Therapy ◽  
Respiratory Intervention

scholarly journals Effects of nasal high flow on nocturnal hypercapnia, sleep, and sympathovagal balance in patients with neuromuscular disorders

2020 ◽  
Author(s):  
Anna Christina Meyer ◽  
Jens Spiesshoefer ◽  
Nina Christina Siebers ◽  
Anna Heidbreder ◽  
Christian Thiedemann ◽  
...  
Keyword(s):  
Neuromuscular Disorders ◽  
Ventilatory Support ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
High Flow ◽  
Apnea Hypopnea Index ◽  
Sympathovagal Balance ◽  
Peripheral Oxygen Saturation ◽  
Depth Analysis ◽  
Nasal High Flow Therapy

Abstract Purpose In neuromuscular disorders (NMD), inspiratory muscle weakness may cause sleep-related hypoventilation requiring non-invasive ventilation (NIV). Alternatively, nasal high flow therapy (NHF) may ameliorate mild nocturnal hypercapnia (NH) through washout of anatomical dead space and generation of positive airway pressure. Ventilatory support by NIV or NHF might have favourable short-term effects on sympathovagal balance (SVB). This study comparatively investigated the effects of NHF and NIV on sleep-related breathing and SVB in NMD patients with evolving NH. Methods Transcutaneous CO2 (ptcCO2), peripheral oxygen saturation (SpO2), sleep outcomes and SVB (spectral analysis of heart rate, diastolic blood pressure variability) along with haemodynamic measures (cardiac index, total peripheral resistance index) were evaluated overnight in 17 patients. Polysomnographies (PSG) were randomly split into equal parts with no treatment, NIV and NHF at different flow rates (20 l/min vs. 50 l/min). In-depth analysis of SVB and haemodynamics was performed on 10-min segments of stable N2 sleep taken from each intervention. Results Compared with no treatment, NHF20 and NHF50 did not significantly change ptcCO2, SpO2 or the apnea hypopnea index (AHI). NHF50 was poorly tolerated. In contrast, NIV significantly improved both gas exchange and AHI without adversely affecting sleep. During daytime, NHF20 and NHF50 had neutral effects on ventilation and oxygenation whereas NIV improved ptcCO2 and SpO2. Effects of NIV and NHF on SVB and haemodynamics were neutral during both night and daytime. Conclusions NHF does not correct sleep-disordered breathing in NMD patients with NH. Both NHF and NIV exert no immediate effects on SVB.

Nasal High-Flow for Weaning Preterm Newborns with Risk of Chronic Lung Disease from nCPAP

2021 ◽  
Author(s):  
Angela Gregoraci Fernández ◽  
Juan José Comuñas Gómez ◽  
Olalla Rodriguez-Losada ◽  
Vanessa Flores España ◽  
Anna Gros Turpin ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
High Flow ◽  
Patient Comfort ◽  
Very Preterm ◽  
Nasal Injury ◽  
Key Points ◽  
Preterm Babies ◽  
Nasal High Flow Therapy ◽  
Outcome Duration ◽  
Group Flow

Objective The aim of the study is to compare the duration of oxygen therapy by using two methods of weaning from nasal continuous positive airway pressure (nCPAP) in very preterm babies. Study Design Between April 2014 and December 2016, 90 preterm <32 weeks and birthweight >1,000 g who, after at least 7 days on nCPAP, were clinically stable on <6 cm H2O and FiO2 <30% were randomly assigned to weaning directly from nCPAP or with nasal high flow therapy (nHFT). In the nCPAP group, pressure was gradually reduced until the infant was stable on 4 cm H2O and then discontinued. In the nHFT group, flow rate was reduced until the infant was stable at 3.l pm and then discontinued. Results Eighty-four infants completed the study. There were no differences between the groups for the primary outcome, duration of oxygen therapy (median 33 [14–48] versus 28 [15–37] days; p = 0.17). The incidence of moderate-to-severe bronchopulmonary dysplasia was similar. Weaning time was shorter in the nCPAP group (p = 0.02), but the failure rate was slightly higher although non-significant. In the nHFT group, we observed better perception of patient comfort and a lower incidence of severe nasal injury. Conclusion Weaning by nHFT compared with weaning directly off nCPAP does not prolong duration of oxygen therapy. Rather, it is associated with better perceptions of infant comfort among parents and lower rates of severe nasal injury. Key Points

scholarly journals Nasal high-flow therapy delivers low level positive airway pressure

2009 ◽  
Vol 103 (6) ◽  
pp. 886-890 ◽  
Author(s):  
R. Parke ◽  
S. McGuinness ◽  
M. Eccleston
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Low Level ◽  
Nasal High Flow Therapy

Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants without the Need for Rescue with Nasal Continuous Positive Airway Pressure

Neonatology ◽  
2018 ◽  
Vol 115 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Sanja Zivanovic ◽  
Alexandra Scrivens ◽  
Raffaella Panza ◽  
Peter Reynolds ◽  
Nicola Laforgia ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Respiratory Support ◽  
Nasal High Flow Therapy

scholarly journals Awake prone positioning of hypoxaemic patients with COVID-19: protocol for a randomised controlled open-label superiority meta-trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041520
Author(s):  
Elsa Tavernier ◽  
Bairbre McNicholas ◽  
Ivan Pavlov ◽  
Oriol Roca ◽  
Yonatan Perez ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Invasive Mechanical Ventilation ◽  
Small Sample ◽  
High Flow ◽  
Occurrence Rate ◽  
Prone Positioning ◽  
Open Label ◽  
Link Type ◽  
Randomised Controlled ◽  
Nasal High Flow Therapy

IntroductionProne positioning (PP) is an effective first-line intervention to treat patients with moderate to severe acute respiratory distress syndrome (ARDS) receiving invasive mechanical ventilation, as it improves gas exchanges and reduces mortality. The use of PP in awake spontaneous breathing patients with ARDS secondary to COVID-19 was reported to improve oxygenation in few retrospective trials with small sample size. High-level evidence of awake PP for hypoxaemic patients with COVID-19 patients is still lacking.Methods and analysisThe protocol of this meta-trial is a prospective collaborative individual participant data meta-analysis of randomised controlled open label superiority trials. This design is particularly adapted to a rapid scientific response in the pandemic setting. It will take place in multiple sites, among others in USA, Canada, Ireland, France and Spain. Patients will be followed up for 28 days. Patients will be randomised to receive whether awake PP and nasal high flow therapy or standard medical treatment and nasal high flow therapy. Primary outcome is defined as the occurrence rate of tracheal intubation or death up to day 28. An interim analysis plan has been set up on aggregated data from the participating research groups.Ethics and disseminationEthics approvals were obtained in all participating countries. Results of the meta-trial will be submitted for publication in a peer-reviewed journal. Each randomised controlled trial was registered individually, as follows: NCT04325906, NCT04347941, NCT04358939, NCT04395144 and NCT04391140.

Sign in / Sign up

Export Citation Format

Share Document