HFNC - will the HIPSTER trial affect your clinical practises?

[Stefan Johansson]

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?

[Francesco Cardona]

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

 

[Guest wangyang]

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

[manino86]

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.

[Arjan te Pas]

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

[ckg]

Bubble cpap is best of all. 

It gives least barotrauma. 

 

[Hamed]

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.

[Bernhard Bungert]

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.