Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Comparing Heated Humidified High Flow Nasal Cannula to Nasal Continuous Positive Airway Pressure As Post-Extubation Respiratory Support in Preterm Infants: A Comprehensive Systematic Review and Meta-Analysis Publisher Pubmed



Am Armanian Amir MOHAMMAD ; B Barekatain BEHZAD ; N Ghasemi Kahrizsangi NEGIN ; P Naseh Ghafoori PAYAM ; M Yazdi MARYAM ; E Mazaheri ELAHEH ; M Nekuei MINA
Authors

Source: Journal of Neonatal-Perinatal Medicine Published:2025


Abstract

BackgroundThis study aims to compare the efficacy and complications of CPAP with HHHFNC, as post-extubation modalities for respiratory support in neonates.MethodsA comprehensive search was conducted in five electronic databases: MEDLINE (via PUBMED), Scopus, Web of Science, Google Scholar, and Embase in September 2022; screening observational and clinical trial studies for eligibility. Primary outcomes of the study included extubation failure at 72 hours and at 7 days.ResultsNine clinical trials were included, encompassing 1471 infants. Extubation failure at 72 days was more common with HHHFNC although insignificantly (OR = 3.40, 95% CI: 0.87, 13.23), but it was found to be significantly higher at 7 days when opting for HHHFNC (OR = 1.65, 95% CI: 1.02, 2.67). In an overall analysis, extubation failure was significantly higher in infants treated with HHHFNC (OR = 1.61, 95% CI: 1.14, 2.26). Among secondary outcomes, nasal trauma was significantly higher when CPAP was utilized (OR = 0.20 95% CI: 0.10, 0.42). Meta-analysis suggests that there are no differences in the risks for BPD (OR = 1.27, 95% CI: 0.79, 2.06), ROP (OR = 0.88, 95% CI: 0.51, 1.52), NEC (OR = 0.63, 95% CI: 0.41, 0.97), PVL (OR = 0.71, 95% CI: 0.29, 2.96), IVH (OR = 1.04, 95% CI: 0.53, 2.04), and mortality (OR = 0.96, 95% CI: 0.56, 1.66).ConclusionAccording to our review, CPAP remains the choice of non-invasive respiratory support modality regarding its lower risk for extubation failure. Although nasal trauma continues to be a challenging side effect for neonates treated with CPAP, other neonatal complications are equally prevalent when comparing CPAP and HHHFCN. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
Related Docs
View other Related Docs
1. Effects of Positioning on Complications of Preterm Infants With Respiratory Distress Syndrome Treated With Nasal Continuous Positive Airway Pressure: A Randomized Clinical Trial, Iranian Journal of Neonatology (2023)
2. Sleep-Wake Cycle in Newborns With 28-32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation, Iranian Journal of Pediatrics (2022)
3. A Comparison of the Effect of Nasal Bi‑Level Positive Airway Pressure and Sigh‑Positive Airway Pressure on the Treatment of the Preterm Newborns Weighing Less Than 1500 G Affiliated With Respiratory Distress Syndrome, International Journal of Preventive Medicine (2016)
Experts (# of related papers)
View all Related Experts
Alireza Sadeghnia (8)
Zohreh Badiee (7)
Other Related Docs
4. Protective Dressings, Injury, and Device Failure in Preterm Infants Receiving Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial, Advances in Skin and Wound Care (2021)
5. Compare the Effects of Continuous Positive Airway Pressure With Two Different Methods to Treat Premature Infants With Respiratory Distress Syndrome, Journal of Isfahan Medical School (2011)
6. Noninvasive Positive Pressure Ventilation or Conventional Mechanical Ventilation for Neonatal Continuous Positive Airway Pressure Failure, International Journal of Preventive Medicine (2014)
7. High-Flow Nasal Cannula Versus Nasal Continuous Positive Airway Pressure in the Management of Respiratory Distress Syndrome, Journal of Isfahan Medical School (2011)
8. High-Flow Nasal Cannula Versus Conventional Oxygen Therapy for Patients With Acute Respiratory Failure in the Emergency Department: A Randomized Controlled Trial, Tanaffos (2024)
9. Initial Treatment of Respiratory Distress Syndrome With Nasal Intermittent Mandatory Ventilation Versus Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial, International Journal of Preventive Medicine (2014)
10. Heated Humidified High Flow Nasal Cannula (Hhhfnc) Is Not an Effective Method for Initial Treatment of Respiratory Distress Syndrome (Rds) Versus Nasal Intermittent Mandatory Ventilation (Nimv) and Nasal Continuous Positive Airway Pressure (Ncpap), Journal of Research in Medical Sciences (2019)
11. Sudden Complete Versus Gradual Weaning From Nasal Continuous Positive Airway Pressure in Preterm Neonates: A Randomized Controlled Trial, Iranian Journal of Neonatology (2019)
12. Early Administration of Surfactant Via a Thin Intratracheal Catheter in Preterm Infants With Respiratory Distress Syndrome: Feasibility and Outcome, Journal of Research in Pharmacy Practice (2015)
13. Nasal High-Frequency Oscillatory Ventilation (Nhfov) Versus Nasal Continuous Positive Airway Pressure (Ncpap) As an Initial Therapy for Respiratory Distress Syndrome (Rds) in Preterm and Near-Term Infants, BMJ Paediatrics Open (2019)
14. A Comparison Between Intravenous Magnesium Sulfate, Lidocaine, and Propofol in Prevention of Respiratory Complications After Tonsillectomy, Journal of Isfahan Medical School (2013)
15. The Effect of Inhaled Budesonide on the Prevention of Chronic Lung Disease in Premature Neonates With Respiratory Distress Syndrome, International Journal of Preventive Medicine (2018)
16. Comparison of Respiratory Complications Between Endotracheal Intubation and Laryngeal Mask Airway (Lma) in Neonates Undergoing Inguinal Herniorrhaphy Under General Anesthesia, Journal of Isfahan Medical School (2017)
17. Comparison of High-Flow Nasal Cannula and Conventional Oxygen Therapy in Treating Covid-19 Patients Referred to the Emergency Department: A Randomized, Single-Blind Clinical Trial, Journal of Emergency Practice and Trauma (2023)
18. Evaluation of Intratracheal Salbutamol Effects in Addition to Surfactant in the Clinical Course of Premature Neonates With Respiratory Distress Syndrome, Journal of Research in Medical Sciences (2023)
19. Risk Factors of Pneumothorax in Preterm Infants, Journal of Isfahan Medical School (2013)
20. Effects of the Time Interval Between Antenatal Corticosteroid Exposure and Delivery on Neonatal Outcome of Premature Infants, Journal of Isfahan Medical School (2013)