Stabilisation of the preterm infant in the delivery room using nasal high flow: A 5—year retrospective analysis

Abstract

Aim This study reviews clinical outcomes after initiating a routine policy of preterm respiratory stabilisation using nasal high flow (HF) in the delivery room (DR). Method This was a retrospective observational cohort study in a single‐centre neonatal intensive care unit and included all neonates born before 32 weeks of gestation between 1 April 2015 and 31 March 2020. Stabilisation measures and outcomes were recorded including oxygen requirements, admission temperature, surfactant administration, invasive ventilation within 72 h of birth, bronchopulmonary dysplasia (BPD) and death. Results There were 491 eligible babies during the 5‐year epoch. 292 were stabilised using HF in the DR. The median admission temperature in babies transferred on HF was 36.8°C, and the median FiO₂ at admission was 25%. 45% of these infants received surfactant. At 72 postnatal hours, 78% were either sustained on HF or were either self‐ventilating in air (SVIA) or receiving low‐flow nasal cannula (LFNC) respiratory support. 27% were intubated within 7 days. At 36 weeks postmenstrual age, 36% of survivors had BPD. Conclusion We have demonstrated that preterm babies <32 weeks can be effectively stabilised on HF in the DR.