The clinical effects of two non-invasive ventilation modes on premature infants with respiratory distress syndrome: A randomized controlled trial

Wang, Hui; Chen, Wenxiang; Zhang, Yinlong

doi:10.1097/md.0000000000033142

Cited by 4 publications

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hypothetically, nHFOV should be more efficient than other NIV modes due to all these effects, at least in some particular clinical situations. Most of the studies performed in the last years confirm the superiority of nHFOV to NCPAP and BiPAP [10,[13][14][15][16][17][18]] and demonstrate at least the non-inferiority of nHFOV to NIPPV [19][20][21][22][23][24][25] as a primary or rescue NIV support in preterm infants with RDS or after extubation from IMV.…”

Section: Discussionmentioning

confidence: 89%

Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units – Results of a Recent Survey

OGNEAN,

Bivoleanu,

Cucerea

et al. 2024

Preprint

View full text Add to dashboard Cite

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS). Multiple noninvasive respiratory support modes are currently available in Romania, but little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). We aimed to identify the usage extent and clinical application of nHFOV in Romania. A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. The questionnaire was addressed to the leaders of all level III Romanian NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10-17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%), heated, humidified high flow nasal cannula (HHHFNC) (61.9%), and nHFOV (11/21 units; 52.4%); 5/11 units reported frequent nHFOV use (in 2 or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). 10/11 units reported setting a mean airway pressure (MAP) equal to the CPAP level plus 1-2 cmH2O on rescue nHFOV after CPAP failure. Both dedicated equipment (45.5%) and hybrid ventilators (63.6%) were used for nHFOV delivery, with face/nasal masks and short binasal prongs being the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV; none of the units mentioned pneumothorax as an adverse effect. Only 3 of the NICUs had a written protocol for nHFOV use. Initial, minimum, and maximum amplitude and initial and minimum MAP settings used were significantly higher with hybrid ventilators as compared to dedicated equipment (p<0.05). Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. A need for training for nHFOV use was identified, and efforts are needed at the national level to develop courses and training sessions, including using simulation workshops, to offer more information on optimal nHFOV use in clinical practice.

show abstract

Section: Discussionmentioning

confidence: 89%

Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units – Results of a Recent Survey

OGNEAN,

Bivoleanu,

Cucerea

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Non-invasive high-frequency ventilation in newborn infants with respiratory distress

Abdel-Latif,

Tan,

Fiander

et al. 2024

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Background Respiratory distress occurs in up to 7% of newborns, with respiratory support (RS) provided invasively via an endotracheal (ET) tube or non‐invasively via a nasal interface. Invasive ventilation increases the risk of lung injury and chronic lung disease (CLD). Using non‐invasive strategies, with or without minimally invasive surfactant, may reduce the need for mechanical ventilation and the risk of lung damage in newborn infants with respiratory distress. Objectives To evaluate the benefits and harms of nasal high‐frequency ventilation (nHFV) compared to invasive ventilation via an ET tube or other non‐invasive ventilation methods on morbidity and mortality in preterm and term infants with or at risk of respiratory distress. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL and three trial registries in April 2023. Selection criteria Randomised controlled trials (RCTs), cluster‐ or quasi‐RCTs of nHFV in newborn infants with respiratory distress compared to invasive or non‐invasive ventilation. Data collection and analysis Two authors independently selected the trials for inclusion, extracted data, assessed the risk of bias, and undertook GRADE assessment. Main results We identified 33 studies, mostly in low‐ to middle‐income settings, that investigated this therapy in 5068 preterm and 46 term infants. nHFV compared to invasive respiratory therapy for initial RS We are very uncertain whether nHFV reduces mortality before hospital discharge (RR 0.67, 95% CI 0.20 to 2.18; 1 study, 80 infants) or the incidence of CLD (RR 0.38, 95% CI 0.09 to 1.59; 2 studies, 180 infants), both very low‐certainty. ET intubation, death or CLD, severe intraventricular haemorrhage (IVH) and neurodevelopmental disability (ND) were not reported. nHFV vs nasal continuous positive airway pressure (nCPAP) used for initial RS We are very uncertain whether nHFV reduces mortality before hospital discharge (RR 1.00, 95% CI 0.41 to 2.41; 4 studies, 531 infants; very low‐certainty). nHFV may reduce ET intubation (RR 0.52, 95% CI 0.33 to 0.82; 5 studies, 571 infants), but there may be little or no difference in CLD (RR 1.35, 95% CI 0.80 to 2.27; 4 studies, 481 infants); death or CLD (RR 2.50, 95% CI 0.52 to 12.01; 1 study, 68 participants); or severe IVH (RR 1.17, 95% CI 0.36 to 3.78; 4 studies, 531 infants), all low‐certainty evidence. ND was not reported. nHFV vs nasal intermittent positive‐pressure ventilation (nIPPV) used for initial RS nHFV may result in little to no difference in mortality before hospital discharge (RR 1.86, 95% CI 0.90 to 3.83; 2 studies, 84 infants; low‐certainty). nHFV may have little or no effect in reducing ET intubation (RR 1.33, 95% CI 0.76 to 2.34; 5 studies, 228 infants; low‐certainty). There may be a reduction in CLD (...

show abstract

Invasive and non-invasive ventilatory strategies for early and evolving bronchopulmonary dysplasia

Sahni,

Bhandari

2023

Seminars in Perinatology

View full text Add to dashboard Cite

The clinical effects of two non-invasive ventilation modes on premature infants with respiratory distress syndrome: A randomized controlled trial

Cited by 4 publications

References 15 publications

Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units – Results of a Recent Survey

Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units – Results of a Recent Survey

Non-invasive high-frequency ventilation in newborn infants with respiratory distress

Invasive and non-invasive ventilatory strategies for early and evolving bronchopulmonary dysplasia

Contact Info

Product

Resources

About