• Clare L Collins, James R Holberton, and Kai König.
• Department of Paediatrics, Mercy Hospital for Women, Melbourne, VIC 3084, Australia.
• J Paediatr Child Health. 2013 Jul 1;49(7):554-6.

AimsThis study aims to determine if there is a difference in the pharyngeal pressure, measured as a surrogate for continuous positive distending airway pressure, delivered to premature infants between two commonly used heated, humidified high-flow nasal cannulae (HHHFNC) devices: Fisher & Paykel Healthcare HHHFNC and Vapotherm 2000i.MethodsPharyngeal pressure measurements were taken from stable premature infants receiving HHHFNC for respiratory support. Flow rates of 2-8 L/min were studied.ResultsNine infants had pharyngeal pressure measurements recorded with both HHHFNC devices at flow rates of 2-8 L/min. There was no difference in pharyngeal pressures recorded between devices at flow rates of 2-6 L/min; measured pressure was linearly associated with flow (R(2) = 0.9). At flow rates of 7 L/min, Vapotherm delivered a mean (standard deviation) pharyngeal pressure of 4.7 (2.2) cmH2 O compared with 4.23 (2.2) cmH2 O by the Fisher & Paykel device (P = 0.04). At a flow of 8 L/min, the mean pharyngeal pressure via Vapotherm was 4.9 (2.2) cmH2 O compared with 4.1 (2.3) cmH2 O with the Fisher & Paykel device (P = 0.05).ConclusionsBoth HHHFNC delivered similar pharyngeal pressures at flow rates of 2-6 L/min. The pressure limiter valve of the Fisher & Paykel device attenuated the pharyngeal pressures at flows of 7 and 8 L/min. Vapotherm trended towards higher delivered pharyngeal pressure at flow rates 7 and 8 L/min, but the clinical significance of the difference remains unclear.© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

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