Non-invasive intermittent positive pressure ventilation vs non-invasive high-frequency oscillatory ventilation as...

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.

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.

• 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.

• 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.