Pilot Study Comparing Different Modes of Non-invasive Ventilation for the Oral Feeding of Preterm Infants (CHOMP)
Feeding Behavior, Chronic Lung Disease
About this trial
This is an interventional treatment trial for Feeding Behavior
Eligibility Criteria
Inclusion Criteria:
- Gestational age of <28 weeks (24+0 to 27+6) with corrected gestational age of 34 weeks
- Neonates requiring respiratory support in the form of nCPAP or HHHFNC at any pressure at 34 weeks corrected gestational age and failing a trial of low flow oxygen or room air
- Full enteral feeding tolerated through a nasogastric tube
Exclusion Criteria:
- Gestational age > 28 weeks
- Neonate requiring biphasic nCPAP
- Mother never at the bedside and no consent for bottle feeds
- Severe nasal breakdown or genetic/neurologic abnormalities which impair oral feeding
Sites / Locations
- Mount Sinai Hospital NICU
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Fisher & Paykel heated humidified high flow nasal cannula
InfantFlow/RAM nasal continuous positive airway pressure
For neonates randomized to HHHFNC, they will be placed on a flow rate equivalent to the pressures of nCPAP they were originally receiving based on a published chart, or stay on the same flow rate prior to randomization. When it is time for oral feeds, the Registered Nurse (RN) will turn the dial of the high flow circuit down to 2 lpm. The baby will then proceed to feed for up to one hour, and afterwards, will be turned back up to the flow rate they were on prior to feeds.
Neonates randomized to the nCPAP arm will remain on the nCPAP pressures they were on before recruitment into the study or match the flow rate they were receiving on high flow based on a published chart. The nCPAP circuit will only be removed when it is time for oral feeds. The respiratory therapist (RT) will exchange the circuit for a low flow nasal cannula which will be set at the flow that is optimal for the baby's gestational age saturations. The baby will then proceed to feed for up to one hour, and afterwards, will be changed back to the nCPAP circuit.