Richter RP, et al. - In this retrospective cohort study with propensity-matched analysis, researchers investigated how postoperative outcomes were influenced by initial extubation to positive airway pressure vs high-flow nasal cannula in neonates and infants after congenital heart surgery. This study was performed at a cardiac ICU within a tertiary care children’s hospital and included patients less than 6 months old initially extubated to either high-flow nasal cannula or positive airway pressure after cardiac surgery with cardiopulmonary bypass (July 2012 to December 2015). Using propensity matching, 49 pairings of patients extubated to high-flow nasal cannula vs positive airway pressure were identified of overall 258 encounters. Findings revealed that as far as prevention of extubation failure after congenital heart surgery was concerned, no superior outcomes were obtained with primary extubation to positive airway pressure vs high-flow nasal cannula. Increased hospital resource utilization was observed in relation to the use of positive airway pressure vs high-flow nasal cannula.