Non-invasive high flow oscillatory ventilation in comparison with nasal continuous positive pressure ventilation for respiratory distress syndrome, a literature review.

Autor: Haidar Shehadeh AM; University of Southampton, Health sciences department, Neonatology, Southampton, UK.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2021 Sep; Vol. 34 (17), pp. 2900-2909. Date of Electronic Publication: 2019 Oct 07.
DOI: 10.1080/14767058.2019.1671332
Abstrakt: Background: Noninvasive high-frequency oscillatory ventilation (NHFOV) keeps the lung open with add-on effective rhythmic oscillations in addition to allowing spontaneous breathing. This review aims at reconstructing the different pieces of available research articles and evidence into a more solid collective evidence for NHFOV in preterm infants with respiratory distress syndrome (RDS).
Methods: A thorough systemic search was conducted in Medline, Embase, Web of Science, Google Scholar, CINAHL, and Cochrane. Randomized controlled trials (RCTs) on preterm infants with RDS comparing NHFOV with nasal continuous positive airway pressure (NCPAP) in terms of PCO 2 change, need for ventilation, duration of respiratory support, mortality air leak, or BPD were included. Data quality assessment and meta-analyses were carried out.
Results: Five RCTs involving 270 preterm infants included in the review. PCO 2 relatively decreased on NHFOV (MD = 3.84, confidence interval (CI) 7.32-0.35, p  = .03). On the other hand, relative risk (RR) of intubation was unquestionably decreased with NHFOV in comparison with NCPAP (RR  =  0.43, CI 0.25-0.75, p  = .003) without statistical heterogeneity I 2  = 0%. Although the risk of mortality was less in NHFOV, the difference was statistically insignificant (RR = 0.72, CI 0.24-2.18, p  = .56). Other outcomes reported in single studies only. Duration of respiratory support was significantly shorter in NHFOV compared with NCPAP (37.35 ± 8.96 versus 49.77 ± 10.33, p  = .009), whereas air leak and BPD were reported in very few cases without a significant difference between the two interventions.
Conclusions: NHFOV improved the PCO 2 elimination and decreased the risk of intubation without a significant change in mortality compared with NCPAP.
Databáze: MEDLINE
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