Comparison of Two Flow Rates of HHHFNC to Prevent Extubation Failure in Preterm Infants
Comparison of Two Flow Rates of HHHFNC to Prevent Extubation Failure in Preterm Infants
This is a randomized controlled trial (RCT) to evaluate the influence of two flow rates (6
 liter/min versus 3 liter/min) of Heated-Humidified High-Flow-Nasal-Cannula (HHHFNC) on rates
 of extubation failure in mechanically ventilated preterm infants.
HHHFNC has been proposed as an alternative to nasal continuous positive airway pressure
 (nCPAP) in neonatal intensive care units (NICUs) for preventing extubation failure. In a
 recent international survey on periextubation practices in extremely preterm infants, nCPAP
 was the most common type of respiratory support used (84%) followed by nasal intermittent
 positive pressure ventilation (55%) and HHHFNC (33%). Moreover, HHHFNC appears to have
 efficacy and safety similar to those of nCPAP when applied immediately post-extubation to
 prevent extubation failure in preterm infants. and resulted in significantly less nasal
 trauma in the first 7 days post-extubation than nCPAP. However, the best flow rates of HHHFNC
 to prevent extubation failure remains to be known.

 This RCT aims to compare the efficacy and safety of postextubation respiratory support via
 HHHFNC at two different flow rates (6 L/min. versus 3 L/min) regarding successful extubation
 after a period of endotracheal positive pressure ventilation. We hypothesized that
 postextubation respiratory support via HHHFNC at a flow rate of 6 L/min. will result in a
 greater proportion of preterm infants being successfully extubated after a period of
 endotracheal positive pressure ventilation compared with HHHFNC at a flow rate of 3 L/min.
Inclusion Criteria:

 -  Infants born at less than 37 weeks' gestation, required endotracheal intubation and
 positive pressure ventilation, and are considered ready for extubation by the clinical
 team. Infants will be enrolled after written informed parental consent is obtained.

 Exclusion Criteria:

 -  Suspected upper airway obstruction, congenital airway malformations, or major
 cardiopulmonary malformations