Noninvasive high-frequency oscillatory ventilation versus nasal intermittent positive pressure ventilation for preterm infants as an extubation support: A systematic review and meta-analysis

作者全名："Wang, Kaixu; Zhou, Xiaofeng; Gao, Shuqiang; Li, Fang; Ju, Rong"

作者地址："[Wang, Kaixu; Zhou, Xiaofeng; Gao, Shuqiang; Ju, Rong] UESTC, Dept Neonatol, Affiliated Womens & Childrens Hosp, Sch Med, Chengdu 610091, Peoples R China; [Li, Fang] Chongqing Med Univ, Women & Childrens Hosp, Chongqing, Peoples R China"

通信作者："Ju, R (通讯作者)，UESTC, Dept Neonatol, Affiliated Womens & Childrens Hosp, Sch Med, Chengdu 610091, Peoples R China."

来源：PEDIATRIC PULMONOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000903826300001

JCR分区：Q1

影响因子：3.1

年份：2023

卷号：58

期号：3

开始页：704

结束页：711

文献类型：Review

关键词：meta-analysis; nasal intermittent positive pressure ventilation; noninvasive high-frequency oscillatory ventilation; preterm infants; reintubation

摘要："ObjectiveWe aimed to explore whether noninvasive high-frequency oscillatory ventilation (NHFOV) could reduce the incidence of reintubation compared with nasal intermittent positive pressure ventilation (NIPPV) in the postextubation phase of preterm infants. MethodsRandomized controlled trials of NHFOV versus NIPPV were searched in PubMed, EMBASE, Cochrane Central, and MEDLINE. Meta-analysis was performed using Review Manager 5.3. ResultsFour randomized controlled trials including 1138 preterm infants were included in this study. Compared with NIPPV, NHFOV reduced the incidence of reintubation in the post-extubation phase of preterm infants (p=0.01, RR=0.72, 95% confidence interval (CI): 0.56 similar to 0.94), and no heterogeneity was found in the four studies (p=0.55, I-2=0%). In the sensitivity analysis, the result showed that there was no significant difference in the incidence of reintubation between NHFOV and NIPPV after excluding one study (p=0. 05, RR=0.76 95% CI: 0.58 similar to 1.00), and no heterogeneity was found in the other three studies (p=0.95, I-2=0%). There was no statistical difference between NHFOV and NIPPV in BPD, air leak, IVH (>= Grade III) and mortality. ConclusionAmong mechanically ventilated preterm infants, compared with NIPPV, NHFOV was potentially beneficial to reduce the incidence of reintubation after extubation and did not increase the risk of complications."

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