Pharyngeal pressure with high-flow nasal cannulae in premature infants

Objective:The aim of this study was to measure pharyngeal pressures in preterm infants receiving high-flow nasal cannulae.Study Design:A total of 18 infants were studied (median gestational age 34 weeks, weight 1.619 kg). A catheter-tip pressure transducer was introduced into the nasopharynx. Flow was sequentially increased to a maximum of 8 l min−1 and decreased to a minimum of 2 l min−1.Result:There was a strong association between pharyngeal pressure and both flow rate and infant weight (P<0.001, r 2=0.61), but not mouth closure. This relationship could be expressed as pharyngeal pressure (cm H2O)=0.7+1.1 F (F=flow per kg in l min−1 kg−1).Conclusion:High-flow nasal cannulae at flow rates of 2 to 8 l min−1 can lead to clinically significant elevations in pharyngeal pressure in preterm infants. Flow rate and weight but not mouth closure are important determinants of the pressure transmitted.

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