ArticleJournal of perinatology : official journal of the California Perinatal Association2014
Work of breathing indices in infants with respiratory insufficiency receiving high-flow nasal cannula and nasal continuous positive airway pressure.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03592134 (Choice and Optimal Settings of Non Invasive Respiratory Support in Preterm Newborns < 30 Gestational Weeks), which is not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Choice and Optimal Settings of Non Invasive Respiratory Support in Preterm Newborns < 30 Gestational Weeks
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- High flow nasal cannula for respiratory support in preterm infants.The Cochrane database of systematic reviews · 2016Pooled it
- Pulmonary function tests in the neonatal intensive care unit and beyond: a clinical review.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Nasal high flow therapy for primary respiratory support in preterm infants.The Cochrane database of systematic reviews · 2023Review
- Effects of nasal high flow on nocturnal hypercapnia, sleep, and sympathovagal balance in patients with neuromuscular disorders.Sleep & breathing = Schlaf & Atmung · 2021Article
- Machine learning for automatic identification of thoracoabdominal asynchrony in children.Pediatric research · 2021Article
- A novel noninvasive approach for evaluating work of breathing indices in a developmental rat model using respiratory inductance plethysmography.Scientific reports · 2020Article
- Diagnostic differences in respiratory breathing patterns and work of breathing indices in children with Duchenne muscular dystrophy.PloS one · 2020Article
- In Vitro Study of the Effect of Breathing Pattern on Aerosol Delivery During High-Flow Nasal Therapy.Pulmonary therapy · 2019Article
- Comparison of aerosol delivery across combinations of drug delivery interfaces with and without concurrent high-flow nasal therapy.Intensive care medicine experimental · 2019Article
- In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance.Pulmonary therapy · 2018Article
- Article
- Nasal high flow treatment in preterm infants.Maternal health, neonatology and perinatology · 2017Review
- Effect of nasal noninvasive respiratory support methods on pharyngeal provocation-induced aerodigestive reflexes in infants.American journal of physiology. Gastrointestinal and liver physiology · 2016Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo compare work of breathing (WOB) indices between two nCPAP settings and two levels of HFNC in a crossover study. STUDY
designInfants with a CGA 28-40 weeks, baseline of HFNC 3-5 lpm or nCPAP 5-6 cmH2O and fraction of inspired oxygen ≤40% were eligible. WOB was analyzed using respiratory inductive plethysmography (RIP) for each of the four modalities: HFNC 3 and 5 lpm, nCPAP 5 and 6 cmH2O. N=20; Study weight 1516 g (±40 g).
resultApproximately 12,000 breaths were analyzed indicating a high degree of asynchronous breathing and elevated WOB indices at all four levels of support. Phase angle values (means) (P<0.01): HFNC 3 lpm (114.7°), HFNC 5 lpm (96.7°), nCPAP 5 cmH2O (87.2°), nCPAP 6 cmH2O (80.5°). The mean phase relation of total breath (PhRTB) (means) (P<0.01): HFNC 3 lpm (63.2%), HFNC 5 lpm (55.3%), nCPAP 5 cmH2O (49.3%), nCPAP 6 cmH2O (48.0%). The relative labored breathing index (LBI) (means) (P≤0.001): HFNC 3 lpm (1.39), HFNC 5 lpm (1.31), nCPAP 5 cmH2O (1.29), nCPAP 6 cmH2O (1.26). Eighty-two percent of the study subjects-respiratory mode combinations displayed clustering, in which a proportion of breaths either occurred predominantly out-of-phase (relative asynchrony) or in-phase (relative synchrony).
conclusionIn this study, WOB indices were statistically different, yet clinically similar in that they were elevated with respect to normal values. These infants with mild-to-moderate respiratory insufficiency demonstrate a meaningful elevation in WOB indices and continue to require non-invasive respiratory support. Patient variability exists with regard to biphasic clustered breathing patterns and the level of supplemental fraction of inspired oxygen ≤40% alone does not provide guidance to the optimal matching of WOB indices and non-invasive respiratory support.
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