Abstract
Nasal high-frequency oscillatory ventilation (NHFOV) has been described to be an advanced version of nasal continuous positive airway pressure (NCPAP). However, its beneficial effects among different studies were inconsistent. The aim of the present study was to assess the effects between NHFOV and NCPAP as the primary respiratory supporting strategies on the intubation rate in preterm infants with respiratory distress syndrome(RDS). Medline, the Cochrane library, the Cochrane Controlled Trials Register, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data Information Site were searched from inception to Jan 1, 2021(Prospero2019 CRD42019129316, date of registration:Apr-23,2019). Pooled data from clinically randomized controlled trials(RCTs) comparing NHFOV with NCPAP as the primary respiratory supporting strategies in preterm infants with RDS were performed using the fixed-effects models whenever no heterogeneity was shown. The primary outcome was intubation rate. Four randomized controlled trials involving 570 participants were included. Comparing with NCPAP, NHFOV resulted in less intubation rate(relative risk(RR):0.47; 95% confidence interval(CI):0.31–0.70, P = 0.0002), and heterogeneity was not found among the trials in the fixed effects model (P = 0.69, I2 = 0%). Similar result also appeared in sensitivity analysis after excluding one study with significant difference(RR:0.49; 95% CI:0.29–0.81, P = 0.006) (P = 0.52, I2 = 0%). Conclusion NHFOV is superior to NCPAP in decreasing the risk of intubation as a primary respiratory supporting strategies in preterm infants suffering from RDS.
Noninvasive high-frequency oscillatory ventilation as respiratory support in preterm infants: a meta-analysis of randomized controlled trials