Heated Humidified High Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure as a Primary Respiratory Support for Mild to Moderate Respiratory Distress Syndrome in Preterm Infants

Introduction: Respiratory Distress Syndrome (RDS) is the most common cause for respiratory distress in newborns. Mild to moderate RDS is treated with non-invasive methods. NCPAP is the most commonly used mode of non-invasive mode in RDS but newer modalities like HFNC also an emerging modality with similar efficacy and has a similar morbidity and mortality profile in managing mild to moderate RDS. Objectives: To compare the efficacy, morbidity & mortality profile of HFNC versus NCPAP as a primary mode of respiratory support for mild to moderate respiratory distress in preterm infants. Methodology: Hospital based Randomized Controlled Trial was done on eligible neonates with RDS. HFNC was delivered through the short nasal prongs and nasal CPAP was delivered through Hudson’s prongs and outcomes of both the methods were compared in terms of efficacy, morbidity and mortality. Results: Out of 100 newborns, 50 were treated with HFNC and 50 were with NCPAP technique. We found there was no significant difference in the primary outcomes among both the groups. Incidence rate of adverse events did not differ in terms of many among both the modalities, but there was a statistically significant difference in incidence of nasal trauma which was more in NCPAP group. And also there was no significant difference in mortality rate among both the groups. Conclusion: HFNC technique is feasible, safe and has similar efficacy along with morbidity profile when compared to NCPAP technique. Both HFNC and NCPAP techniques reduce the requirement of mechanical ventilation and need for surfactant instillation.