Nasal high-frequency oscillatory ventilation versus nasal continuous positive airway pressure for respiratory distress syndrome in preterm infants: A systematic review and meta-analysis.
This systematic review and meta-analysis aimed to evaluate whether nasal high-frequency oscillatory ventilation (NHFOV) reduces the intubation rate compared to nasal continuous positive airway pressure (NCPAP) as a primary respiratory support strategy in preterm infants with respiratory distress syndrome (RDS).
We systematically searched Medline, the Cochrane Library, EMBASE, the Chinese National Knowledge Infrastructure (CNKI), and the Wanfang Database from inception to December 2025 for randomized controlled trials (RCTs). We included RCTs comparing NHFOV with NCPAP as the initial respiratory support for preterm infants with RDS. Data were pooled using a random-effects model. The primary outcome was the rate of endotracheal intubation.
Five RCTs involving 912 preterm infants were included. Compared with NCPAP, NHFOV significantly reduced the intubation rate (relative risk [RR]: 0.51; 95% confidence interval [CI]: 0.37-0.68; P < 0.001). No significant heterogeneity was observed among the studies (P = 0.79; I2 = 0%).
As a primary respiratory support strategy for preterm infants with RDS, NHFOV is superior to NCPAP in reducing the need for endotracheal intubation.
We systematically searched Medline, the Cochrane Library, EMBASE, the Chinese National Knowledge Infrastructure (CNKI), and the Wanfang Database from inception to December 2025 for randomized controlled trials (RCTs). We included RCTs comparing NHFOV with NCPAP as the initial respiratory support for preterm infants with RDS. Data were pooled using a random-effects model. The primary outcome was the rate of endotracheal intubation.
Five RCTs involving 912 preterm infants were included. Compared with NCPAP, NHFOV significantly reduced the intubation rate (relative risk [RR]: 0.51; 95% confidence interval [CI]: 0.37-0.68; P < 0.001). No significant heterogeneity was observed among the studies (P = 0.79; I2 = 0%).
As a primary respiratory support strategy for preterm infants with RDS, NHFOV is superior to NCPAP in reducing the need for endotracheal intubation.