Nursing perceptions of high-flow nasal cannulae treatment for very preterm infants

Authors

  • Calum T Roberts,

    Corresponding author
    1. Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
    • Correspondence: Dr Calum T Roberts, Newborn Research Centre, The Royal Women's Hospital, Level 7, 20 Flemington Road, Parkville, Vic. 3052, Australia. Fax: +613 8345 3789; email: calum.roberts@thewomens.org.au

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  • Brett J Manley,

    1. Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
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  • Jennifer A Dawson,

    1. Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
    3. Critical Care and Neurosciences Division, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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  • Peter G Davis

    1. Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
    3. Critical Care and Neurosciences Division, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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  • Conflict of interest: The authors have no conflicts of interest to disclose.

Abstract

Aim

This study aims to assess nursing perceptions of high-flow nasal cannulae (HFNC) in comparison with nasal continuous positive airway pressure (NCPAP) as post-extubation respiratory support for very preterm infants.

Methods

A standardised questionnaire form was distributed in person to nursing staff in The Royal Women's Hospital neonatal unit, where HFNC had been recently introduced in the context of a clinical trial. Nursing staff were eligible to participate if they routinely cared for infants receiving respiratory support.

Results

The survey was completed by 99/144 eligible nurses. The majority of the 99 nurses surveyed felt that HFNC was less likely than NCPAP to prevent re-intubation of infants 24–26 weeks' gestation but equally likely to prevent re-intubation of infants 28–30 weeks' gestation. Nurses preferred NCPAP for post-extubation support of 24- and 26-week infants, and HFNC for 28- and 30-week infants, despite being less experienced with HFNC. Perceptions of HFNC compared with NCPAP included increased ease-of-use, improved infant comfort and reduced nasal trauma.

Conclusions

Neonatal nurses preferred NCPAP for post-extubation support of infants <28 weeks' gestation and HFNC for infants of 28 or 30 weeks' gestation. Nurses accurately predicted varying efficacy of HFNC across different gestational ages, consistent with the findings of a contemporaneous randomised trial. In the context of clinical non-inferiority, as shown in the randomised trial, nursing preference for HFNC over NCPAP in preterm infants ≥28 weeks' gestation supports the use of HFNC as post-extubation support in this population.

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