High Flow Weaning in Preterm Infants: Physiology and Outcomes

• Research type

  Research Study

• Full title

  Weaning high flow nasal cannula support in preterm infants: Exploring clinical and physiological predictors of success.

• IRAS ID

  265622

• Contact name

  Christopher J O'Brien

• Contact email

  christopher.o'brien@nuth.nhs.uk

• Sponsor organisation

  The Newcastle Upon Tyne Hospitals NHS Foundation Trust

• Duration of Study in the UK

  1 years, 10 months, 1 days

• Research summary

  Premature infants are born before their lungs are fully developed, and often need help with breathing for weeks or months after birth. High flow nasal cannula therapy (high flow) is a commonly used type of breathing support on the neonatal unit, and consists of small nasal prongs that deliver heated and humidified air, with or without oxygen, at rates of up to 8L/minute.

  As a baby matures and their breathing improves, the rate of high flow is reduced, but there is currently no consensus on precisely how and when to wean. Weaning too rapidly may lead to instability, poor growth and re-escalation of breathing support; a stressful experience for both infants and parents. In contrast, excessively slow reduction may prolong hospital admission, increase baby-parent separation and delay oral feeding.

  It is clear that careful changes in breathing support are essential to improve outcomes for babies and their families, but this is an area that is currently unexplored with no clear guidance or evidence for the best way to achieve this. Our study will assess in detail the changes in breathing that occur with reductions in high flow rates and identify factors associated with success.

  The study will take place on the neonatal unit at the Royal Victoria Infirmary. High flow will be weaned in a structured manner according to our guideline, and measurements of effort breathing made a set time points. This will assess clinical and physiological factors predictive of readiness to wean, ultimately aiming to improve use of high flow support.

• REC name

  North East - Newcastle & North Tyneside 1 Research Ethics Committee

• REC reference

  19/NE/0317

• Date of REC Opinion

  7 Jan 2020

• REC opinion

  Further Information Favourable Opinion