Comparison of heated humidified high-flow nasal cannula versus nasal continuous positive airway pressure as a primary mode of respiratory support for respiratory distress in newborns: A tertiary care-based study from Western India

Objectives: One of the main causes of newborn morbidity and mortality is respiratory distress (RD) syndrome. Although it is frequently used for non-invasive assistance, nasal continuous positive airway pressure (NCPAP) can result in nasal damage and poor tolerability. Although there is little comparative data, the heated humidified high-flow nasal cannula (HHHFNC) is a kinder substitute. The objective of the study is to evaluate the results of newborns with RD treated with NCPAP as the primary support against HHHFNC. Material and Methods: In a prospective interventional research, 101 newborns were assigned to either NCPAP ( n = 50) or HHHFNC ( n = 51) within 12 h of birth. Mortality, complications, time to full feeds, ventilator demand, baseline features, and respiratory support duration were documented. Results: Groups were comparable in gestation, birth weight, and distress severity. Overall ventilator need and mortality were similar (high-flow nasal cannula [HFNC] 25.5% vs. NCPAP 40%; p = 0.149; mortality 7.8% vs. 8%; p = 1.0). Term infants on HFNC needed significantly less ventilator support (20% vs. 55.6%; p = 0.03). HFNC was associated with lower nasal trauma (0% vs. 8%; p = 0.04) and faster achievement of full feeds (3.98 vs. 4.82 days; p = 0.04). Conclusion: With the added advantages of less nasal trauma and faster enteral feeding, HHHFNC is just as effective as NCPAP for moderate paediatric RD. It is easy to use, safe, and well-tolerated.