J Perinatol. 2008 Jan;28(1):42-7. Epub 2007 Nov 8.

OBJECTIVE: The aim of this study was to measure pharyngeal pressures in preterm infants receiving high-flow nasal cannulae. STUDY DESIGN: A total of 18 infants were studied (median gestational age 34 weeks, weight 1.619 kg). A catheter-tip pressure transducer was introduced into the nasopharynx. Flow was sequentially increased to a maximum of 8 l min(-1) and decreased to a minimum of 2 l min(-1). RESULT: There was a strong association between pharyngeal pressure and both flow rate and infant weight (P<0.001, r (2)=0.61), but not mouth closure. This relationship could be expressed as pharyngeal pressure (cm H(2)O)=0.7+1.1 F (F=flow per kg in l min(-1) kg(-1)). CONCLUSION: High-flow nasal cannulae at flow rates of 2 to 8 l min(-1) can lead to clinically significant elevations in pharyngeal pressure in preterm infants. Flow rate and weight but not mouth closure are important determinants of the pressure transmitted.