Please select the eligibility criteria that correspond to the clinical trial below.
Title: Comparison of Humidified High Flow Nasal Cannula to Nasal Continuous Positive Airway Pressure for Non-Invasive Respiratory Support in Neonates
Brief Summary: We hypothesize that the success rate for keeping babies extubated (without a breathing tube for assisted mechanical ventilation), defined as the proportion of infants remaining extubated for a minimum of 72 hours, will be equivalent among infants managed with nasal CPAP compared to humidified high flow nasal cannula (HHFNC).


Options:
A: Inclusion Criteria:

* Preterm infants admitted to the NICU at University Hospital of North Norway, Tromsoe, Norway (single center study)

  * Gestational age (GA) \< 34 weeks
  * Corrected age \< 34 weeks
  * Receiving nasal CPAP for respiratory distress
  * Respiratory "stable": FiO2 \< 30%, pCO2 \< 8,5 kPa and pH \> 7.25.
* GA \< 29 weeks: Respiratory "stable" over last 72 h.
* GA 29-33 weeks: Respiratory "stable" over last 24 h.

Exclusion Criteria:

1. Congenital anomalies
2. Ongoing treatment for hypoglycemia or infection
3. Other intercurrent disease requiring frequent blood sampling
B: Inclusion Criteria:

* 1) receiving NCPAP ventilatory support at \> 72 hrs. of age and 2) requiring FiO2 21-50% on NCPAP.

Exclusion Criteria:

* FiO2 \>50%, presence of pneumothorax or pleural effusion, anatomical abnormalities of the airway, lungs, or esophagus, or cyanotic congenital heart defect.
C: Inclusion Criteria:

1. Birth weight \> 1000 grams and \> 27 weeks gestation
2. Candidate for non-invasive respiratory support as a result of:

   1. an intention to manage the infant with non-invasive (no endotracheal tube) respiratory support from birth initiated in the first 24 hours of life
   2. an intention to extubate an infant being managed with intubated respiratory support to non-invasive support

Exclusion Criteria:

1. Birth weight \< 1000 grams
2. Estimated gestation \< 29 weeks
3. Participation in a concurrent study that prohibits the use of HHFNC
4. Active air leak syndrome
5. Infants with abnormalities of the upper and lower airways; such as Pierre- Robin, Treacher-Collins, Goldenhar, choanal atresia or stenosis, cleft lip and/or palate, or
6. Infants with significant abdominal or respiratory malformations including tracheo-esophageal fistula, intestinal atresia, omphalocele, gastroschisis, and congenital diaphragmatic hernia.
D: Inclusion Criteria:

* Infants born greater than or equal to 28 weeks (28+0) and less than 37 weeks (36+6) gestation
* CPAP pressure of 5 cm H2O
* FiO2 requirement = or \<0.30
* Clinically stable on these CPAP parameters for 24 hours pre-randomization:

  * Respiratory rate less than 60
  * No significant chest recession
  * No apnea requiring bagging and/or
  * Not more than 6 apneas requiring stimulation in the preceding 24 h.
  * Average saturation \> or = 87%
  * Satisfactory ABG (pH\> 7.25, PCO2 \< 60, and Base deficit \< -8)

Exclusion Criteria:

* Life threatening congenital anomalies
* Congenital cyanotic heart diseases
* Congenital airway or chest wall abnormalities
* Pulmonary hypoplasia
* Known or suspected to have a neuromuscular disorder
* Congenital neurological disorder, severe IVH (grade 3 or 4), PVL and hydrocephalus

Answer: C