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Continuous positive airway pressure (CPAP) has become the gold standard for noninvasive respiratory support in preterm infants. Recent “high-flow” adaptations of nasal cannula support deliver heated and humidified gas at flow rates >1 L/minute, producing distending pressure to the lungs. High-flow nasal cannula (HFNC) support has been used in many neonatal units during the last decade, primary because the method is easy to apply, involves minimal equipment, and appears comfortable. However, the safety and efficacy of HFNC support in premature infants is largely unknown, with some speculation that the methodology could produce lung injury.
Investigators randomized 303 extubated infants (gestational age, <32 weeks) at three Australian intensiv…