In July 2016, Reynolds and colleagues published a single-center, observational pilot study in Archives of Disease in Childhood—Fetal and Neonatal Edition, titled “Stabilization of Premature Infants in the Delivery Room with Nasal High Flow.” The study included 28 premature (<30 weeks of gestation) infants with primary outcomes being assessment of the feasibility on an early approach measured by successful clinical stabilization with Vapotherm’s Hi-VNI® Technology and subsequently successful transfer to the NICU from the delivery room.11. Reynolds P, Leontiadi S, Lawson T, et al. Stabilisation of premature infants in the delivery room with nasal high flow Archives of Disease in Childhood – Fetal and Neonatal Edition 2016;101:F284-F287.Read Full Text 25 of the 28 infants (89%) were successfully stabilized and transferred. 3 (11%) had to be intubated.
The study results showed that infants born at less than 25 weeks of gestation were among the least successful to be stabilized with nasal High Flow therapy. All 3 of the infants that had to be intubated were born at 23 or 24 weeks. For the 25 infants successfully stabilized and transferred, the average body temperature on admission to the NICU was 36.9°C (range 36.3°C–38.2°C) and the average FiO2 was 0.29 (range 0.21–0.60). 9 infants (36%) were admitted on room air and 12 (48%) received rescue administration of surfactant.
The protocol followed in this study dictated that the Vapotherm Precision Flow® be set to 37°C with starting flows of 6 or 7 LPM, and a maximum 8 LPM flow rate. The authors note that the technology could be set up in 2 minutes with an additional 2-3 minutes of heating time needed to reach the 37°C, during which time the clinicians assessed the infants and performed routine checks of resuscitation equipment. Additionally, the infants’ preductal pulse and oxygen saturation were monitored, with acceptable initial values being >100 bpm and SaO2 >40%, while spontaneously breathing.
The researchers noted two instances of technical difficulties with the equipment, both of which were resolved quickly. The study found Vapotherm’s Hi-VNI Technology was feasible for the stabilization of premature infants in the delivery room.