Project Details

A Phase 2 Crossover Trial of Pressure Targeted High Flow Therapy in Premature Infants

Alan Groves, MBChB

Summary

BACKGROUND: Around 2 million very preterm (<32 weeks’ gestation) infants are born globally each year, and these infants have significant risk of respiratory failure due to lung immaturity. GAP: Continuous Positive Airway Pressure (CPAP) is the current mainstay of respiratory support in preterm infants, but it can be injurious, disruptive and expensive to deliver. High flow nasal cannula (HFNC) interfaces are better tolerated by patients, but don’t produce the guaranteed distending pressure necessary to prevent lung collapse. HYPOTHESIS: A novel approach of pressure targeted high flow therapy (where airway pressures are monitored on HFNC interfaces) can provide the efficacy of CPAP with the comfort and ease of use of HFNC. METHODS: Initial prospective, non-randomized phase to optimize delivery of pressure targeted high flow. Subsequently a phase 2 randomized, crossover trial in a cohort of infants born at 26-32 week’s gestation who are stable on CPAP therapy RESULTS: Pending. IMPACT: If demonstrated to be effective and more comfortable for infants an approach of Pressure Targeted High Flow could significantly improve outcomes in preterm infants and also increase the numbers of newborns able to receive effective respiratory support in Low- and Middle-Income countries.