Pediatr Pulmonol. 2025 Oct;60(10):e71328. doi: 10.1002/ppul.71328.
ABSTRACT
OBJECTIVE: To assess lung aeration changes during clinically directed transitions from CPAP to HFNC in preterm infants using Electrical Impedance Tomography (EIT).
DESIGN: Prospective, observational study.
SETTING: Single-center, Level IV Neonatal Intensive Care Unit.
PATIENTS: Infants born < 32 weeks gestational age (GA) undergoing a clinically indicated transition from CPAP to HFNC following ≥ 2 weeks of respiratory support.
INTERVENTIONS: EIT data were recorded for 30-60 min before and after transition.
MAIN OUTCOME MEASURES: The primary outcome was change in end-expiratory lung impedance (ΔEELI). Infants were followed for 7 days following transition to assess for transition failure.
RESULTS: From 15 subjects, 4257 total breaths were analyzed. No significant difference in %∆EELI was found between HFNC and CPAP (Median ∆: -1.0%; IQR -3.6% to 6.0%; p = 0.78). The largest %∆EELI decrease (-9.8%) occurred in the subject who failed transition.
CONCLUSIONS: Transitioning from CPAP to HFNC did not consistently decrease lung aeration in stable preterm infants. In the infant who failed transition, a distinct respiratory pattern was observed using EIT, characterized by a decrease in EELI and frequent recruitment breaths. These findings suggest better methods are needed to individualize and titrate respiratory support at the bedside for preterm infants.
PMID:41090276 | DOI:10.1002/ppul.71328
