Optiflow – humidifier set at 37 oC (NB – use non invasive setting on the Fisher & Paykel MR850 humidifier).Vapotherm - 34 - 35º C for flow rate 5 L/min.Flow 4-8 L/min (lower flow 5-6 L/min may be sufficient for smaller babies, flow rates > 6 L/min in infants 0.4, increased work of breathing or respiratory incidents, increase flow by 1L/min every 30-60minutes judged by clinical response, until maximum of 8L/min flow.Prongs: MUST be smaller than 50% of patient’s nares (tight fit of nasal cannulae may generate pressure of 6-10cmH2O at flow as low as 1.5-2 L/min) see images below.The level of pressure generated in each individual is variable and not fully predictable 3 It is recommended that small calibre cannulae are used (obstructing less than 50% of nares) to allow for leak around the nares and thus reduce risk of pressure build-up in the airways 3. Some units report starting around 5L/min and adjust accordingly.

HHFNC reduce the discomfort, mucosal damage and drying of secretions seen with non-humidified gases 3.įlows used vary from 1-6L/min, up to 8L/min max. As it is non-invasive, HHFNC also helps to reduce ventilator-associated pneumonia and other lung injuries 5. Reported benefits include a reduction in both ventilation days and re-intubations 5. Reported advantages of HHFNC over CPAP are: less trauma to the nares, simple application, easier to care for and access the baby, including for skin-to-skin and feeding 1,2,3,6. HHFNC are being used as an alternative to CPAP, weaning from CPAP, for apnoea of prematurity and post extubation 2,5,7. It is common in both term and preterm infants 3,4. The use of HHFNC in the UK and around the world in neonatal units is high 2,3. They are usually less than 1cm long and should occlude less than 50% of the area of nares 1.

HFNC may deliver positive end expiratory pressure. Humidified High-flow nasal cannulae (HHFNC) are small, tapered cannulae that are used to deliver heated, humidified high-flow air and blended oxygen.

High flow nasal cannula pediatrics