Use of NHFOV versus NIPPV for the respiratory support of preterm
newborns: a meta-analysis
Abstract
Background: Noninvasive ventilation for newborns has become the
preferred mode of treatment for respiratory diseases.
Objectives: This meta-analysis evaluated and compared the
efficacy and safety of noninvasive high-frequency oscillatory
ventilation (NHFOV) and nasal intermittent positive-pressure ventilation
(NIPPV) for use with newborns. Study design: We searched the
PubMed, Cochrane Library, EMBASE, Web of Science,CNKI, Wanfang and VIP
databases from inception to April 1, 2022. Randomized controlled trials
(RCTs) and cohort studies that evaluated and compared the effectiveness
of NHFOV and NIPPV in newborns were included in the review and
meta-analysis, which followed the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.
Results: Twenty-three articles involving 2,924 patients were
included. Compared to NIPPV, NHFOV showed a significantly greater
reduction in the intubation rates in initial respiratory support and in
the reintubation rate without time limit. While reintubation rates
within 72 h and 7 days of post-extubation respiratory support were
similar. Significant decreases in the duration of non-invasive
ventilation and length of hospital stay were observed with NHOFV, which
also: reduced PaCO2 levels, enhanced PaO2 levels and the SpO2/FiO2 ratio
at 1 h and 24 h after non-invasive respiratory support; and
significantly reduced the risk of bronchopulmonary dysplasia and apnea.
Conclusions: Compared to NIPPV, NHFOV is a safer and more
effective neonatal respiratory support modality. The potential benefits
of NHFOV as a mode of respiratory support for very low birth weight or
extremely preterm infants should be investigated in larger trials.