Neonatal Transport on Humidified High Flow
(HHF) via Nasal Cannulae


Reviewed by Clinical Practice Committee
February 2016
Clinical Guidelines Back Newborn Services Home Page
Introduction Indications Set Up
Monitoring Managing Clinical Deterioration References


Humidified high flow (HHF) is used for the transfer of infants that are already established and stable on HHF. It is not currently used in the retrieval setting.


Humidified high flow is frequently used as a mode of respiratory support for infants with mild respiratory dysfunction.
Its use in neonatal transport is recent.

Published data suggests that it is well tolerated and there have been no adverse events experienced. The available data concludes that HHF is a safe mode of respiratory support to use in the neonatal transport setting.

This guideline is to be used in addition to the Newborn Services Clinical Guideline ‘Humidified High Flow Oxygen or Air’.


Set Up

Refer to Newborn Services Clinical Guideline Humidified High Flow Oxygen or Air for correct application of HHF/sizing of prongs etc.


Managing clinical deterioration

If an infant shows signs of receiving insufficient respiratory support (increased WOB, apnoea, desaturations, significant increase in Fio2 etc) check the follow:


Boyle M, Chaudhary, R, Kent S, O'Hare S, Broster S, Dassios T. (2014) High-flow nasal cannula on transport: moving with the times. Acta Pædiatrica. Vol 103 (5): 181
Boyle M, Kent S, Dassios T, Chaundhary R, O ‘ hare S, Broster S. (2015). Conference Paper: High-flow nasal cannula on neonatal transfer - A year's experience. Transport of high-risk neonates, Genova. Available from: High-flow nasal cannula on neonatal transfer - A year 27s_experience Accessed on 01/05/2015
3 Roberts C. (2015). Highflow on the Highway. PSANZ breakfast session
4 Schlapbach L, Schaefer J, Brady A, Mayfield S, Schibler A. (2014). High-flow nasal cannula (HFNC) support in interhospital transport of critically ill children. Intensive Care Med. Apr;40(4):592-9
5 Tsakmakis M, Bagga G, Hayward A, Webb J. (2014). Audit of High flow on Transport undertaken by CHANTS – the Welsh experience. From: Prog.pdf Accessed on 01/05/2015