The aim of the article is to compare the efficacy and safety of non-invasive high-frequency oscillatory ventilation (NHFOV) against those of non-invasive intermittent positive pressure ventilation (NIPPV) as non-invasive respiratory support after extubation in extremely low birth weight infants. We conducted a single center retrospective study to compare outcomes of extremely low birth weight infants being extubated for the first time, who received NIPPV or NHFOV as non-invasive respiratory support after extubation. The primary outcome was treatment failure of NHFOV or NIPPV within 7 days after extubation. From May 2016 to June 2024, 175 infants were included. The mean ± SD birth weight was 972 ± 145 g with a gestational age of 27.3 ± 1.6 week. Treatment failure within 7 days after extubation occurred in 22 of the 82 infants (26.8%) in the NIPPV group and in 13 of the 93 infants (14.0%) in the NHFOV group (risk difference, 12.8 percentage points; 95% confidence interval, 0.1 to 25.5.7; p = 0.03). However, there was no significant between-group difference in reintubation rates within 7 days after extubation.Conclusion: In this population of extremely low birth weight infants, NHFOV resulted a significantly lower rate of treatment failure than did NIPPV when used as post-extubation respiratory support in extremely low birth weight infants.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> What is Known: • NIPPV reduces the extubation failure rate more effectively than NCPAP but does not significantly reduce the incidence of BPD. • To date, there is insufficient evidence comparing NHFOV and NIPPV as post-extubation respiratory support in preterm infants. What is New: • NHFOV appears more promising than NIPPV in reducing extubation failure when used as post-extubation respiratory support in extremely low birth weight infants. • Both two modalities demonstrated comparable safety profiles. </entry> </row> </tbody> </tgroup> </Table>

Non-invasive intermittent positive pressure ventilation vs non-invasive high-frequency oscillatory ventilation as post-extubation support in extremely birth weight infants: a retrospective study

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发表日期：

2025年4月21日

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Wanjun Wang,
Rong Tan,
Wenbin Dong

摘要

The aim of the article is to compare the efficacy and safety of non-invasive high-frequency oscillatory ventilation (NHFOV) against those of non-invasive intermittent positive pressure ventilation (NIPPV) as non-invasive respiratory support after extubation in extremely low birth weight infants. We conducted a single center retrospective study to compare outcomes of extremely low birth weight infants being extubated for the first time, who received NIPPV or NHFOV as non-invasive respiratory support after extubation. The primary outcome was treatment failure of NHFOV or NIPPV within 7 days after extubation. From May 2016 to June 2024, 175 infants were included. The mean ± SD birth weight was 972 ± 145 g with a gestational age of 27.3 ± 1.6 week. Treatment failure within 7 days after extubation occurred in 22 of the 82 infants (26.8%) in the NIPPV group and in 13 of the 93 infants (14.0%) in the NHFOV group (risk difference, 12.8 percentage points; 95% confidence interval, 0.1 to 25.5.7; p = 0.03). However, there was no significant between-group difference in reintubation rates within 7 days after extubation.

Conclusion: In this population of extremely low birth weight infants, NHFOV resulted a significantly lower rate of treatment failure than did NIPPV when used as post-extubation respiratory support in extremely low birth weight infants.

What is Known:

• NIPPV reduces the extubation failure rate more effectively than NCPAP but does not significantly reduce the incidence of BPD.

• To date, there is insufficient evidence comparing NHFOV and NIPPV as post-extubation respiratory support in preterm infants.

What is New:

• NHFOV appears more promising than NIPPV in reducing extubation failure when used as post-extubation respiratory support in extremely low birth weight infants.

• Both two modalities demonstrated comparable safety profiles.