Here you will find a summary of the current literature that may inform how to set flows with Optiflow Junior in your unit.


There is direction in the literature to guide how flow should be set and titrated. There are a number of possible approaches based on current trends in practice.

The following approaches have some supporting evidence. All three studies delivered Nasal High Flow therapy between 2 and 8L/min.

  • Flow based: Deliver a set flow to all infants
    - Collins et al (2013) initiated flow for all patients at 8L/min
  • Titrate to effect (observational): At the clinician’s discretion
    - Manley et al (2013) initiated flow at 5 or 6L/min
  • Combination of dose by weight and titrating to effect.
    - Yoder et al. (2013) initiated flow between 3 and 5L/min based on infant weight


It may be useful to think about setting flow in terms of L/kg/min. Recent evidence supports flows of equal to or above 2L/kg/min in the pediatric population are associated with4,5,7,8,9:

  • Clinically relevant pharyngeal pressure
  • Improved breathing pattern
  • Rapid unloading of respiratory muscles
  • Reduced work of breathing