Work of breathing using high-flow nasal cannula in preterm infants

J Perinatol. 2006 Aug;26(8):476-80. doi: 10.1038/ Epub 2006 May 11.


Objective: To compare the work of breathing (WOB) in premature neonates supported with high-flow nasal cannula (HFNC) and nasal continuous positive airway pressure (NCPAP).

Study design: Eighteen preterm neonates <2.0 kg on HFNC or NCPAP support were studied in a random order. A ventilator was used to deliver 6 cm H2O of NCPAP with nasal prongs. High-flow nasal cannula delivered with Vapotherm (VAPO) at 3, 4 and 5 l/min was used. Tidal ventilation was obtained using respiratory inductance plethysmography calibrated with face-mask pneumotachography. An esophageal balloon estimated pleural pressure from which changes in end distending pressure were calculated. Inspiratory, elastic and resistive WOB and respiratory parameters were calculated.

Results: No differences were found in the WOB for all settings. Changes in end distending pressure did not vary significantly over all device settings except VAPO at 5 l/min.

Conclusion: In these preterm infants with mild respiratory illness, HFNC provided support comparable to NCPAP.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Continuous Positive Airway Pressure
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / physiopathology*
  • Infant, Premature, Diseases / therapy
  • Lung Compliance
  • Oxygen Inhalation Therapy*
  • Respiration
  • Respiratory Mechanics
  • Respiratory Tract Diseases / physiopathology*
  • Respiratory Tract Diseases / therapy
  • Tidal Volume
  • Work of Breathing*