Abstract Objective To evaluate the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) in preventing extubation failure in neonates. Methods A literature search was performed using PubMed, Cochrane Library, FMRS, and CNKI to collect the randomized controlled trials (RCTs) and quasi-RCTs which compared the clinical efficacy of HHHFNC and nasal continuous positive airway pressure (NCPAP) in preventing extubation failure in neonates. The identified studies were finally selected after full-text search and quality assessment and then subjected to a Meta analysis using RevMan 5.3. Results Five eligible trials involving 1040 neonates were included in the Meta analysis. The Meta analysis showed that there was no significant difference in treatment failure rate between the HHHFNC and the NCPAP groups. The HHHFNC group had significantly lower incidence rates of nasal trauma (OR=0.49, 95% CI:0.34-0.71, P=0.0001) and pneumothorax (OR=0.27, 95% CI:0.07-0.97, P=0.04) than the NCPAP group, but there were no significant differences in the duration to reach full oral feedings and the incidence rates of serious adverse events or other complications between the two groups, such as in-hospital mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity. Conclusions HHHFNC is safe and effective in preventing extubation failure in neonates.
Jatana KR, Oplatek A, Stein M, et al. Effects of nasal continuous positive airway pressure and cannula use in the neonatal intensive care unit setting[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(3):287-291.
[2]
de Klerk A. Humidified high-flow nasal cannula:is it the new and improved CPAP?[J]. Adv Neonatal Care, 2008, 8(2):98-106.
[3]
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
Manley BJ, Owen LS, Doyle LW, et al. High-flow nasal cannulae in very preterm infants after extubation[J]. N Engl J Med, 2013, 369(15):1425-1433.
[8]
Yoder BA, Stoddard RA, Li M, et al. Heated, humidified highflow nasal cannula versus nasal CPAP for respiratory support in neonates[J]. Pediatrics, 2013, 31(5):e1482-e1490.
[9]
Sreenan C, Lemke RP, Hudson-Mason A, et a1. High-flow nasal cannulae in the management of apnea of prematurity:a comparison with conventional nasal continuous positive airway pressure[J]. Pediatrics, 2001, 107(5):1081-1083.
[10]
Shelly MP, Lloyd GM, Park GR. A review of the mechanisms and methods of humidification of inspired gases[J]. Intensive Care Med, 1988, 14(1):1-9.
[11]
Tarnow-Mordi WO, Reid E, Grifiths P, et a1. Low inspired gas temperature and respiratory complications in very low birth weight infants[J]. J Pediatr, 1989, 114(3):438-442.
[12]
Wilkinson D, Andersen C, O'Donnell CP. High flow nasal cannula for respiratory support in preterm infants[J]. Cochrane Database Syst Rev, 2011, (5):CD006405.
[13]
Volsko TA, Fedor K, Amadei J, et a1. High flow through a nasal cannula and NCPAP effect in a simulated infant model[J]. Respir Care, 2011, 56(12):1893-1900.
