The HIPSTER trial was published in NEJM the other week and it showed clearly that HFNC was inferior to nasal CPAP in the initial management of preterm infants (≥28 weeks). You can read the paper here: http://www.nejm.org/doi/full/10.1056/NEJMoa1603694

@AllThingsNeonatal wrote a great blog post about his reflections on the paper. 

I would be great to hear about your non-invasive ventilatory support practises. Does anyone use HFNC as initial support, if so, what are your strategies and guidelines?

Here is the link for lazy people like me :-) to the blog post:

 

WE never use HFNC as initial ventilatory support strategies of preterm infants.

We did not have good results when we used HFNC as primary therapy.We prefer  now Bubble CPAP o NC ventilation and now use HFNC only for weaning from CPAP.

We don't use it. The hipster compared the commonly used settings, assuming that it is comparable treatment.

Bubble cpap is best of all. 

It gives least barotrauma. 

 

On 10/2/2016 at 3:11 PM, Stefan Johansson said:

The HIPSTER trial was published in NEJM the other week and it showed clearly that HFNC was inferior to nasal CPAP in the initial management of preterm infants (≥28 weeks). You can read the paper here: http://www.nejm.org/doi/full/10.1056/NEJMoa1603694

@AllThingsNeonatal wrote a great blog post about his reflections on the paper. 

I would be great to hear about your non-invasive ventilatory support practises. Does anyone use HFNC as initial support, if so, what are your strategies and guidelines?

3

We actually usually use HFNC as a step down from CPAP. However, sometimes we give it a try from the start after extubation in preterms who are doing well and have a good compliance " static compliance" on Resp. function test before extubation. Our starting flow is about 3~5 L/Kg.

We weaning we go at a rate of 0.5 L q 12 hrs.

We dont use HFNC as a Initial Support For Premies under 32 Weeks. 

Therefore was a lot of unreflected use as CPAP-Weaning Strategy: since we started with "the Todd-Procedere" Premies loose CPAP earlier without the need of HFNC. 

We use HFNC instead of CPAP For late preterms with TTPN with heavy breathing to lower our Airleak rate.