J Perinat Med. 2025 Apr 22. doi: 10.1515/jpm-2025-0033. Online ahead of print.
ABSTRACT
OBJECTIVES: To compare the rates of Chronic Lung Disease (CLD) between premature infants weaned with either Continuous Positive Airway Pressure (CPAP) or High Velocity Nasal Cannula (HVNC).
METHODS: This was a retrospective, observational cohort study at a level IV NICU including infants <34 weeks gestational age (GA) on NIV (noninvasive ventilation) for at least 5 days. Maternal and infant demographics and clinical data from the infant’s hospital course were collected. Infants were assigned to CPAP (n=175) and HVNC (n=48) cohorts based on which modality they were treated with for most of their time on NIV.
RESULTS: Demographics and clinical characteristics were similar between the CPAP group and the HVNC group. The rates of CLD were significantly higher in the HVNC group as compared to the CPAP group (58.3 vs. 24.6 %, p<0.001). After logistic regression analysis was performed accounting for GA, invasive respiratory support requirement, sepsis and administration of antenatal corticosteroids, the HVNC group was found to be almost 4 times more likely to develop CLD. Further analysis using propensity score matching yielded similar results.
CONCLUSIONS: When used as the primary modality of noninvasive support, preterm infants on HVNC were more likely to develop CLD than those on CPAP.
PMID:40258246 | DOI:10.1515/jpm-2025-0033
