Efficacy and Complications of Humidified High-Flow Nasal Cannula Versus Nasal Continuous Positive Airway Pressure in Neonates with Respiratory Distress Syndrome After Surfactant Therapy

Background: Neonatal respiratory distress syndrome (RDS) is a problem that often occurs in preterm neonates. Objectives: The present study was conducted to compare the efficacy and complications of humidified high flow nasal cannula (HFNC) with those of nasal continuous positive airway pressure (NCPAP) after surfactant therapy in neonates with RDS. Methods: This clinical trial was conducted on 60 neonates with the gestational age of 28 - 36 weeks suffering from RDS and admitted to Fatemieh Hospital in Hamadan, Iran, during 2017. Initially, all newborns were administered with exogenous surfactant. Subsequently, the participants were randomly assigned into two groups of HFNC (group 1) and NCPAP (group 2) to receive respiratory support. The NCPAP group was managed with a mask or nasal prong. The HFNC group was given warm and humid oxygen through a short binasal cannula proportional to the weight of each neonate until the recovery of respiratory distress. Results: The mean one-minute Apgar scores were obtained as 6.23 ± 1.55 and 6.60 ± 1.07 in the HFNC and NCPAP groups, respectively. Furthermore, the mean five-minute Apgar scores were 8.0 ± 1.11 and 8.17 ± 0.95 in these groups, respectively. The mothers and neonates in both groups were comparable in terms of demographic and clinical data, except for gestational age and neonatal gender (P = 0.05). Furthermore, there was no statistically significant difference between the HFNC and NCPAP groups regarding the respiratory outcomes (P = 0.05). Conclusions: As the findings indicated, humidified high flow nasal cannula was as effective as nasal continuous positive airway pressure in the management of respiratory distress in premature neonates with the gestational age of 28 - 36 weeks. Consequently, these two interventions could be used interchangeably for the provision of respiratory support among these patients.