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Meta-Analysis
. 2019 Mar 15;20(1):58.
doi: 10.1186/s12931-019-1023-0.

Noninvasive high-frequency oscillatory ventilation as respiratory support in preterm infants: a meta-analysis of randomized controlled trials

Jing Li  1 , Xiaoxia Li  1 , Xianmei Huang  1 , Zhiqun Zhang  2
Affiliations
Meta-Analysis

Noninvasive high-frequency oscillatory ventilation as respiratory support in preterm infants: a meta-analysis of randomized controlled trials

Jing Li et al. Respir Res. .

Abstract

Background: Noninvasive high-frequency oscillatory ventilation (nHFOV), a relatively new modality, is gaining popularity despite scarce evidence. This meta-analysis was designed to evaluate the efficacy and safety of nHFOV as respiratory support in premature infants.

Methods: We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL from inception of the database to January 2019. All published randomized controlled trials (RCTs) evaluating the effect of nHFOV therapy with nasal continuous positive airway pressure (nCPAP) or biphasic nCPAP (BP-CPAP) in newborns for respiratory support were included. All meta-analyses were performed using Review Manager 5.3.

Results: A total of 8 RCTs involving 463 patients were included. The meta-analysis estimated a lower risk of intubation (relative risk = 0.50, 95% confidence interval of 0.36 to 0.70) and more effective clearance of carbon dioxide (weighted mean difference = - 4.61, 95% confidence interval of - 7.94 to - 1.28) in the nHFOV group than in the nCPAP/BP-CPAP group.

Conclusions: Our meta-analysis of RCTs suggests that nHFOV, as respiratory support in preterm infants, significantly remove carbon dioxide and reduce the risk of intubation compared with nCPAP/BP-CPAP. The appropriate parameter settings for different types of noninvasive high-frequency ventilators, the effect of nHFOV in extremely preterm infants, and the long-term safety of nHFOV need to be assessed in large trials.

Keywords: Bronchopulmonary dysplasia; Continuous positive airway pressure; Noninvasive high-frequency oscillatory ventilation; Preterm infants.

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Conflict of interest statement

Ethics approval and consent to participate

As the paper did not involve any human or animal, the ethical approval was not required.

Competing interests

None of the investigators declare any real or perceived conflicts of interest pertaining to the subject of this manuscript.

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Figures

Fig. 1
Fig. 1
A PRISMA flow chart for the selection of eligible studies
Fig. 2
Fig. 2
Meta-analysis of the effect of CO2 removal with the use of nHFOV or nCPAP/BP-CPAP
Fig. 3
Fig. 3
Meta-analysis of rate of intubation with the use of nHFOV or nCPAP/BP-CPAP
See this image and copyright information in PMC

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