CPAP and High Flow Therapy

The introduction of CPAP transformed the field of neonatology as the reliable distending pressure it produces prevents alveolar collapse, improves gas exchange, and reduces work of breathing. But CPAP therapy comes at a cost — high rates of nasal injury, disruption of skin-to-skin care, high nursing and RT workload.

Babies, parents and nurses love high-flow nasal cannula (HFNC) therapy as it is gentler, less intrusive and lower maintenance. But it’s also less effective than CPAP as it doesn’t generate a reliable PEEP — the degree of leak around the high flow prongs is impossible to assess yet is a prime driver of PEEP generation.

Measuring PEEP generation while on HFNC with a small, soft nasopharyngeal catheter provides an opportunity to combine the efficacy of CPAP with the ease of use of high flow. 

Is it time for the next transformation of NICU care, Pressure Targeted High Flow?