• Deeparaj Hegde, Jayashree Mondkar, Harshad Panchal, Swati Manerkar, Bonny Jasani, and Nandkishor Kabra.
• Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal and General Hospital, and #Department of Neonatology, Seth GS Seth Medical college and KEM Hospital; Mumbai, India. Correspondence to: Dr Deeparaj Hegde, Department of Neonatology, LTMMC and LTMG hospital, Sion (West), Mumbai, India. princedeepraj81@gmail.com.
• Indian Pediatr. 2016 Feb 1; 53 (2): 129-33.

ObjectiveTo compare the outcomes of preterm infants with respiratory distress initiated on either Heated Humidified High Flow Nasal Cannula or Nasal Continuous Positive Airway Pressure as a primary mode of respiratory support.Study DesignProspective observational cohort study.SettingTertiary care level III neonatal intensive care unit.Participants88 preterm infants between 28 to 34 weeks of gestation with mild to moderate respiratory distress within 6 hours of birth.InterventionEligible infants were treated either with Heated Humidified High Flow Nasal Cannula (n=46) or Nasal Continuous Positive Airway Pressure (n=42).Primary OutcomeNeed for mechanical ventilation within 72 hrs of initiating support.ResultsBaseline demographic characteristics were comparable between the two groups. There was no difference in the requirement of mechanical ventilation between Heated Humidified High Flow Nasal Cannula (19.5%) and Nasal Continuous Positive Airway Pressure (26.2%) groups [RD-0.74 (95% CI 0.34-1.62; P =0.46)]. Moderate or severe nasal trauma occurred less frequently with Heated Humidified High Flow Nasal Cannula (10.9%) in comparison to Nasal Continuous Positive Airway Pressure (40.5%) (P= 0.004).ConclusionsHeated Humidified High Flow Nasal Cannula was comparable to Nasal Continuous Positive Airway Pressure as a primary respiratory support for preterm infants with respiratory distress, with lesser incidence of nasal trauma.

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