Efficacy of non-invasive high frequency oscillatory ventilation as post-extubation respiratory support in preterm neonates: a randomized controlled trial

Abstract

Objective To compare the efficacy of non-invasive high-frequency oscillatory ventilation (NHFOV) with nasal continuous positive airway pressure (NCPAP) in preterm infants aged 26+0~31+6 weeks as post-extubation respiratory support. Methods A total of 114 infants admitted to Department of Neonatology, Jiulongpo District People's Hospital and Diagnosis and Treatment Center for Neonates of Children's Hospital of Chongqing Medical University during January 2017 to January 2019 were recruited, and randomized to NCPAP group (n=58, control) and NHFOV group (n=56) by envelope extraction. The primary outcomes were treatment failure and need for re-intubation within 7 d after extubation. Secondary outcomes included duration of noninvasive ventilation, length of hospitalization, mortality, and incidences of pneumothorax, bronchopulmonary dysplasia (BPD) at 36 weeks of postmenstrual age or discharge, intracranial hemorrhage (IVH) and necrotizing enterocolitis (NEC). Results The rate of treatment failure and need for re-intubation within 7 d after extubation was significantly lower in the NHFOV group than the NCPAP group (14.2% vs 31.0%, P=0.033). There were no statistically differences in all other secondary outcomes between the 2 groups. Conclusion NHFOV can improve the success rate of weaning and reduce the need for re-intubation as compared with NCPAP in preterm infants after extubation.

Keywords

• preterm infants
• non-invasive high-frequency oscillatory ventilation
• nasal continuous positive airway pressure