Optiflow vs Vapotherm as extended weaning mode from nasal continuous positive airway pressure in preterm infants ≤ 28 weeks gestational age

INTRODUCTION Current evidence supports continuous NCPAP weaning. Humidified high flow nasal cannula (HHFNC) reduces NCPAP time in infants <28 weeks gestational age (GA) without increasing morbidity. The aim of the study was to compare the two most frequently used HHFNC devices in weaning from NCPAP. METHODOLOGY We performed a retrospective matched-pair case-control study of infants ≤28 GA born in a single tertiary neonatal centre managed with OptiflowTM (OP) or Vapotherm® (VP) after being weaned from NCPAP. Patients were matched for antenatal steroid doses, delivery mode, birth plurality, GA, birthweight, gender, surfactant doses, length of mechanical ventilation and length of NCPAP. Outcome measures were duration of HHFNC, low-flow nasal cannula, nasal bridge lesions, pneumothorax, bronchopulmonary dysplasia, postnatal steroids, necrotising enterocolitis, sepsis, intraventricular haemorrhage, retinopathy of prematurity, length of stay, discharge weight and mortality. Results were displayed as median (interquartile range) or ratio (percentage). Statistical analysis was performed using Mann-Whitney U- and Chi-Square-Test. RESULTS 70 patients were recruited retrospectively. 35 infants were weaned from NCPAP to OP and 35 infants to VP with gestational ages and birthweights of 27 GA (26-27) and 1010g (835-1165) and 27 GA (26-28) and 960g (788-1191), respectively. There was no statistically significant difference in any outcome measure. Infants managed with VP required a not statistically significant shorter length of time on HHFNC and low-flow nasal cannula. CONCLUSIONS OptiflowTM and Vapotherm® seem to be equally effective and safe for weaning from NCPAP. However infants weaned to Vapotherm® appear to spend less time on non-invasive respiratory support. This article is protected by copyright. All rights reserved.