Efficacy of heated humidified high-flow nasal cannula as initial treatment for preterm infants with respiratory distress: a meta-analysis / 中华围产医学杂志

ABSTRACT

Objective To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) as the primary means of respiratory support for preterm infants with mild or moderate respiratory distress syndrome (RDS).Methods Randomized controlled trials (RCTs) about HHHFNC and/or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS were searched in PubMed,EMBASE,Cochrane library,Chinese Journal Full-text Database (CJFD),Wanfang Data base,VIP Database and China Biology Medicine disc (CBM).Meta-analysis was conducted with Review Manager 5.2 software to compare HHHFNC and CPAP groups in the outcomes ofpreterm infants with RDS,which included initial support failure,nasal trauma,pre-discharge mortality and incidences of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) before discharge.Results Eight randomized trials,including 1 400 preterm infants with RDS were included.Results of the meta-analysis demonstrated that no significant difference in the percentage of initial support failure was observed between the two groups (RR=1.22,95％CI0.94-1.59,P=0.13),and HHHFNC was associated with decreased risk for nasal trauma (RR=0.35,95％CI0.24-0.52,P＜0.001).There was no significant difference in the incidence of death,BPD,PDA or gas leaking before discharge between the two groups.Conclusions HHHFNC is an efficient respiratory support for preterm infants (gestational age over 28 weeks) with mild or moderate RDS.