Rapid systematic review shows that using a high-flow nasal cannula is inferior to nasal continuous positive airway pressure as first-line support in preterm neonates

Acta Paediatrica
Francesca ConteSalvatore Fasola

Abstract

We reviewed using a high-flow nasal cannula (HFNC) as first-line support for preterm neonates with, or at risk of, respiratory distress. This rapid systematic review covered biomedical databases up to June 2017. We included randomised controlled trials (RCTs) published in English. The reference lists of the studies and relevant reviews we included were also screened. We performed the study selection, data extraction, study quality assessment, meta-analysis and quality of evidence assessment following the Grading of Recommendations Assessment, Development and Evaluation system. Pooled results from six RCTs covering 1227 neonates showed moderate-quality evidence that HFNC was associated with a higher rate of failure than nasal continuous positive airway pressure (NCPAP) in preterm neonates of at least 28 weeks of gestation, with a risk ratio of 1.57. Low-quality evidence showed no significant differences between HFNC and NCPAP in the need for intubation and bronchopulmonary dysplasia rate. HFNC yielded a lower rate of nasal injury (risk ratio 0.50). When HFNC failed, intubation was avoided in some neonates by switching them to NCPAP. HFNC had higher failure rates than NCPAP when used as first-line support. Subsequently switching ...Continue Reading

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Citations

Jul 12, 2019·International Journal of Technology Assessment in Health Care·Nigel FleemanBen Nj Shaw
Feb 23, 2020·Frontiers in Pediatrics·Andres MaturanaSteven M Donn
Jul 2, 2019·NeoReviews·Walid A Hussain, Jeremy D Marks
May 22, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Shaam BruetFrederic Dutheil
Aug 21, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Laura SandShalini Ojha

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