Introduction: Nasal continuous positive airway pressure (nCPAP)
is one of the most commonly used non-invasive ventilation modes in
neonates with transient tachypnea of the newborn (TTN). Non-invasive
high frequency oscillatory ventilation (nHFOV) is an non-invasive
ventilation mode that has been increasingly used in neonatal respiratory
disorders. Based on the unique physiologic advantages that nHFOV offers,
we hypothesized that nHFOV might result in a decrease in the duration of
non-invasive positive pressure ventilation in neonates with TTN.
Methods: Late preterm and term infants > 34 weeks’
gestation were included in the study. Infants were randomized into nHFOV
or nCPAP groups. Treatment was started with standard settings in both
groups. Infants who met treatment failure criteria were switched to
nasal intermittent mandatory ventilation for further positive-pressure
support. Results: Total of 60 infants were included in the
study. Thirty of these infants were included in the nHFOV group and 30
were included in the nCPAP group. There was no difference between the
groups in terms of duration of positive-pressure ventilation; however,
it showed a decreasing trend in the nHFOV group (21 hours, IQR
[16-68] vs 15 hours, IQR [11-33]; p=0.09). After adjusting for
confounders, the nHFOV group had a shorter duration of positive-pressure
ventilation compared with the nCPAP group (mean difference: 16.3 hours;
95% confidence interval [CI], 0.7 to 31.9; p=0.04).
Conclusion: Non-invasive high frequency oscillatory ventilation
can shorten the duration of positive-pressure ventilation and
supplemental oxygen in TTN.
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