The role of high flow therapy in optimising cardiorespiratory stability during intubation of premature infants

Premature infants frequently require endotracheal intubation, a procedure associated with significant risk of cardiorespiratory instability, including hypoxaemia, desaturation and bradycardia. High flow nasal cannula (HFNC) therapy has been proposed to optimise oxygenation and stability during intubation; however, its role in neonatal practice remains unclear. This systematised review evaluates the evidence for the use of HFNC during intubation of preterm infants, with a focus on cardiorespiratory stability. The findings suggest that HFNC may reduce episodes of desaturation and bradycardia during neonatal intubation, although further large scale studies are needed.

Malgorzata M Lomis
Advanced Neonatal Nurse Practitioner
Mersey and West Lancashire Teaching Hospital NHS Trust, Prescot
malgorzata.lomis@merseywestlancs.nhs.uk
orcid.org/0009-0001-8657-814X

Suzanne Threadgold
Lecturer in Neonatal Nursing
School of Nursing and Midwifery, University of Salford, Manchester
s.e.threadgold@salford.ac.uk

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Keywords

high flow therapy; neonatal infant; premature infant; intubation; hypoxaemia; cardiorespiratory stability

Key points

Neonatal intubation is frequently associated with hypoxaemia and brady-cardia, particularly in preterm infants.
High flow nasal cannula therapy may help maintain oxygenation during apnoeic periods of intubation.
Evidence from neonatal studies suggests potential benefits, but data remain limited.
Further high quality neonatal trials are required before routine implementation can be recommended.

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VOLUME 18 ISSUE 4/JULY 2022

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