Nasal Cannula Use in the Preterm Infant: Oxygen or Pressure?

In the October issue of Pediatrics , Walsh et al1 describe the use of nasal cannulae in a population of 1508 infants of 90%) when their cannulae were removed. Infants who failed the oxygen-removal challenge had a mean calculated Fio2 of 0.26. The authors speculate that one reason for continued use of the cannula was lack of knowledge of the actual delivered Fio2, an explanation that would not account for the use of a nasal cannula to deliver room air, used in 22 of their infants, some of whom had flows as high as 2 L/minute. Indeed, 7 infants receiving room air failed to tolerate room air without the cannula. The current experience by Walsh et al raises a number of questions. Is the use of an oxygen challenge more meaningful than the actual clinical prescription of oxygen and method of … Address correspondence to Neil N. Finer, MD, Department of Pediatrics, University of California, 200 W Arbor Dr, 8774, San Diego, CA 92103-8774. E-mail: nfiner{at}ucsd.edu