Nasal High-Frequency Oscillatory Ventilation in Preterm Infa
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A research was conducted to see whether nasal high-frequency oscillatory ventilation (NHFOV) as a primary mode of respiratory support, as opposed to nasal continuous airway pressure (NCPAP), would minimize the need for intrusive mechanical ventilation in preterm infants with respiratory distress syndrome (260/7–336/7 weeks of gestational age [GA]) (RDS).

This multicenter randomized controlled trial was conducted in 18 tertiary neonatal intensive care units. A total of 302 preterm infants born at a GA of 260/7–336/7 weeks with a diagnosis of RDS were randomly assigned to either the NCPAP (n = 150) or the NHFOV (n = 152) group. The primary outcome was the need for invasive mechanical ventilation during the first 7 days after birth.

--Treatment failure occurred in 15 of 152 infants (9.9%) in the ­NHFOV group and in 26 of 150 infants (17.3%) in the NCPAP group.

--In the subgroup analysis, NHFOV resulted in a significantly lower rate of treatment failure than did NCPAP in the strata of 26+0/7–29+6/7weeks of GA (11.9 vs. 32.4%) and birth weight less than 1,500 g (10.4 vs. 29.6%).

--The rate of thick secretions causing an airway obstruction was higher in the NHFOV group than in the NCPAP group (13.8 vs. 5.3%).

--No significant differences in other secondary outcomes were found between the NHFOV and NCPAP groups.

Finally, NHFOV was not found to be superior to NCPAP in terms of the primary outcome when used as the primary respiratory support for RDS in infants aged 26+0/7 to 33+6/7 weeks of GA. NHFOV appeared to be more effective than NCPAP in preterm infants with a gestational age of less than 30 weeks in the subgroup analysis.