{"doi":"10.1002/ppul.71328","title":"Evaluating Clinically Directed Continuous Positive Airway Pressure to High Flow Nasal Cannula Transitions in Stable Preterm Infants Using Electrical Impedance Tomography: A Prospective, Observational Study","abstract":"OBJECTIVE: To assess lung aeration changes during clinically directed transitions from CPAP to HFNC in preterm infants using Electrical Impedance Tomography (EIT). DESIGN: Prospective, observational study. SETTING: Single-center, Level IV Neonatal Intensive Care Unit. PATIENTS: Infants born < 32 weeks gestational age (GA) undergoing a clinically indicated transition from CPAP to HFNC following ≥ 2 weeks of respiratory support. INTERVENTIONS: EIT data were recorded for 30-60 min before and after transition. MAIN OUTCOME MEASURES: The primary outcome was change in end-expiratory lung impedance (ΔEELI). Infants were followed for 7 days following transition to assess for transition failure. RESULTS: From 15 subjects, 4257 total breaths were analyzed. No significant difference in %∆EELI was found between HFNC and CPAP (Median ∆: -1.0%; IQR -3.6% to 6.0%; p = 0.78). The largest %∆EELI decrease (-9.8%) occurred in the subject who failed transition. CONCLUSIONS: Transitioning from CPAP to HFNC did not consistently decrease lung aeration in stable preterm infants. In the infant who failed transition, a distinct respiratory pattern was observed using EIT, characterized by a decrease in EELI and frequent recruitment breaths. These findings suggest better methods are needed to individualize and titrate respiratory support at the bedside for preterm infants.","journal":"Pediatric Pulmonology","year":2025,"id":578123,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8202,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":655711,"name":"Natalie Napolitano","orcid":"0000-0002-1498-8465","position":1,"is_corresponding":false},{"id":1488172,"name":"F. Blair Simmons","orcid":null,"position":2,"is_corresponding":false},{"id":1488173,"name":"Rachel Mackenzie","orcid":null,"position":3,"is_corresponding":false},{"id":1488174,"name":"Kelle Matthews","orcid":null,"position":4,"is_corresponding":false},{"id":472286,"name":"Elizabeth E. Foglia","orcid":null,"position":5,"is_corresponding":false},{"id":1470883,"name":"Howard B. Panitch","orcid":"0000-0001-8440-283X","position":6,"is_corresponding":false},{"id":875337,"name":"David M. Rub","orcid":"0000-0003-3687-7325","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T02:58:20.638044Z","pmid":"41090276","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}