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Summary: Work of breathing using high-flow nasal cannula in preterm infants.

Topic: Pressure – Neonatal

Saslow, JG, Aghai, ZH, Nakhla, TA, Lawrysh, R, Stahl, GE, & Pyon, KH (Journal of Perinatol 2006: 26, 476-80).

Saslow et al evaluate the use of high flow therapy (HFT; Vapotherm 2000i) with respect to breathing effort and airway pressure development. The most intriguing findings in this paper are that HFT up to 5 l/min does not produce more airway pressure than CPAP set to 6 cmH2O. In fact, these authors demonstrate that at 5 l/min airway pressure is significantly less that with a CPAP of 6. Although complex, this finding may have an explanation based on the concepts of gas flow properties where greater flow currents in the nasopharyngeal cavity may actually unload pressure forces to the airways.

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Vapotherm High Velocity Therapy

CAUTION: US Federal law restricts this device to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at https://vapotherm.com/resources/support/precision-flow-reference/. For spontaneously breathing patients. High Velocity Therapy (HVT) does not provide total ventilatory requirements of the patient. It is not a ventilator. Decisions surrounding patient care depend on the physician’s professional judgment in consideration of all available information for the individual case, including escalation of care depending on patient condition.