Nasal High-Flow Therapy during Neonatal Endotracheal Intubation.

To the Editor: Hodgson et al. (April 28 issue)(1) concluded that nasal high-flow oxygen therapy delivered through a nasal cannula improved success in the first attempt at neonatal intubation as compared with standard treatment. Although we agree that adequate apneic oxygenation increases the allowable time for laryngoscopy and intubation, we are not convinced that nasal high-flow therapy is necessarily the best technique for maximizing the oxygen content of alveolar air. Appropriate apneic oxygenation can be achieved by means of a simple nasal cannula, deep laryngeal insufflation, transnasal humidified rapid-insufflation ventilatory exchange, or nasal high-flow therapy.(2,3) Each of these techniques consistently . . .