Comparison of Continuous positive airway pressure versus High flow nasal cannula for Oral feeding Preterm infants (CHOmP): randomized pilot study

Abstract

Objective

To assess the feasibility of conducting a study comparing nasal continuous positive airway pressure (nCPAP) or heated, humidified, high flow nasal cannula (HHHFNC) on oral feeding in preterm infants.

Study design

Randomized controlled pilot study in a level III NICU, of infants’ born ≤28°^/7weeks who at 34°^/7weeks post menstrual age (PMA) were dependent on noninvasive ventilation (NIV). Infants were randomized evenly to nCPAP or HHHFNC groups and orally fed on low-flow oxygen. The primary outcomes of enrollment and retention were assessed.

Results

We enrolled 40 infants and 12 completed the study in the nCPAP group versus 13 in the HHHFNC group. Using our respiratory and feeding protocols, we showed overall enrollment and retention rates (95%CI) at 0.66 (0.54, 0.77) and 0.63 (0.48, 0.78), respectively. Breastfeeding rates were 82% in the nCPAP group and 76% in the HHHFNC group. Infants in the HHHFNC group reached full feeds 7 days earlier than those in the nCPAP group

Conclusions

Based on our retention rate, an adequately powered randomized controlled trial can be performed to confirm or refute that HHHFNC is associated with achieving oral feeds earlier.

Trial registration

United States National Library of Medicine (www.clinicaltrials.gov) Identifier: NCT02055339. First posted 2/5/2014.

Keywords:

• Breastfeeding
• CPAP
• HHHFNC
• oral feeds
• preterm

Acknowledgements

We thank Sarah Hutchinson, PhD and Heather McDonald-Kinkaid, PhD at the MiCare Research Center for providing editorial assistance in preparing this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The data that support the findings of this study are available from the corresponding author, SLL, upon reasonable request.

Additional information

Funding

Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Center (MiCare) at Mount Sinai Hospital in Toronto. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team grant [FRN87518].