Pediatric Reports
Association Between High-Flow Nasal Cannula Duration and Bronchopulmonary Dysplasia Severity in Very Preterm Infants
By Saleh S. Algarni, Talal Aljarbou, Modhi Alenazi and 3 others.
Abstract
Background
High-flow nasal cannula (HFNC) is widely used during respiratory weaning in very preterm infants, but its relationship with bronchopulmonary dysplasia (BPD) is unclear.
Methods
This retrospective cohort included infants born at <32 weeks’ gestation (2017–2025) who started HFNC before BPD assessment at 36 weeks’ postmenstrual age (PMA) or discharge. The exposure was HFNC days before assessment; a landmark analysis restricted exposure to the period before 32 weeks’ PMA. Logistic and ordinal logistic regression were used.
Results
Of 641 infants, 232 (36.2%) developed BPD. Each additional HFNC day before assessment was associated with higher odds of BPD (adjusted OR 1.043, 95% CI 1.022–1.065) and greater severity (adjusted OR 1.047, 95% CI 1.027–1.067). HFNC days accrued before 32 weeks’ PMA were not associated with BPD after adjustment (OR 1.023, 95% CI 0.988–1.060). Most infants with Grade 3 BPD started HFNC only after assessment.