Raising airway pressure is one of the most important interventions at the disposal of clinicians treating patients with respiratory failure. Non-invasive ventilatory strategies such as CPAP (Continuous Positive Airway Pressure) or HFNC (High Flow Nasal Cannula) are commonly used in young children, such as premature infants and those with bronchiolitis.
Despite widespread usage and rapid adoption of HFNC systems, the mechanisms of action are not well understood with a limited number of studies published in the literature. Preterm infants often receive flow rates of up to 8 litres per minute with no robust data about airway pressures delivered. There is no consistent data to guide what flow should be prescribed and how the relationship between these variables should be adjusted in individual infants or for example about optimal weaning strategies.
Our research aims to study the airway physiology associated with HFNC use in infants (through both direct and indirect measurements) to increase understanding of how HFNC works and to optimise the delivery of this non-invasive ventilation modality. Dr Zheyi Liew, Clinical Research Fellow, works on this collaborative project with Dr Chris O’Brien and Neonatologists Dr Alan Fenton and Dr Sundeep Harigopal from Ward 35, Royal Victoria Infirmary, Newcastle. A pilot study on the feasibility and repeatability of measurement of various aspects of respiratory physiology during HRNC therapy was previously carried out by Dr S. Gopalakaje.