• Clare L Collins, James R Holberton, Charles Barfield, and Peter G Davis.
• Department of Pediatrics, Mercy Hospital for Women, Melbourne, Victoria, Australia. ccollins@mercy.com.au
• J. Pediatr. 2013 May 1;162(5):949-54.e1.

ObjectiveTo determine whether postextubation respiratory support via heated, humidified, high-flow nasal cannulae (HHHFNC) results in a greater proportion of infants younger than 32 weeks' gestation being successfully extubated after a period of endotracheal positive pressure ventilation compared with conventional nasal continuous positive airway pressure (NCPAP).Study DesignWe randomly assigned preterm ventilated infants to Vapotherm HHHFNC or NCPAP after extubation. The primary outcome, extubation failure, was defined by prespecified failure criteria in the 7 days after extubation.ResultsA total of 132 ventilated infants younger than 32 weeks' gestation were randomized to receive either HHHFNC (n = 67) or NCPAP (n = 65). Extubation failure occurred in 15 (22%) of the HHHFNC group compared with 22 (34%) of the NCPAP group. There was no difference in the number of infants reintubated in the first week. Treatment with HHHFNC reduced the nasal trauma score 3.1 (SD 7.2) versus NCPAP 11.8 (SD 10.7), P < .001.ConclusionsHHHFNC and NCPAP produced similar rates of extubation failure.Copyright © 2013 Mosby, Inc. All rights reserved.

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