Muhsen et al.,55 Muhsen W, Roy R. A comparative study of HHHFNC and NCPAP in preventing reintubation in extreme preterm infants born at less than 30-week gestation. J Matern Fetal Neonatal Med. 2018;31:3197-200. 2018 |
NBs 24-29 weeks PCA |
26 |
Observational comparative retrospective study |
The study demonstrates that HFNC is similarly safe and effective compared to CPAP as a noninvasive post-extubation respiratory support in extremely preterm infants. |
Konda et al.,66 Konda KC, Lewis LE, Bhat RY, Purkayastha J, Kanaparthi S. Heated humidified high-flow nasal cannula versus nasal continuous positive airway pressure for the facilitation of extubation in preterm neonates with respiratory distress. IJN. 2018;9:14-20. 2018 |
NBs 27-34 weeks PCA |
64 |
Observational comparative prospective study |
Although it is a modality with lower incidence of nasal trauma, HFNC does not seem to be as effective as CPAP in the management of preterm infants with respiratory distress after extubation. |
Soonsawad et al.,88 Soonsawad S, Swatesutipun B, Limrungsikul A, Nuntnarumit P. Heated humidified high-flow nasal cannula for prevention of extubation failure in preterm infants. Indian J Pediatr. 2017;84:262-6. 2017 |
NBs < 32 weeks PCA |
49 |
Randomized controlled trial |
The extubation failure rate was not statistically different between the NBs who were receiving HFNC or CPAP support in the post-extubation period. |
Ferguson et al.,99 Ferguson KN, Roberts CT, Manley BJ, Davis PG. Interventions to improve rates of successful extubation in preterm infants a systematic review and meta-analysis. JAMA Pediatrics. 2017;171:165-74. 2017 |
|
867 |
Systematic review and meta-analysis |
Preterm infants should be extubated with transition to noninvasive respiratory support. In the pooled analysis, there was no difference between HFNC and CPAP regarding treatment failure within seven days. |
Kang et al.,1515 Kang W-Q, Xu B-L, Liu D-P, Zhang YD, Guo J, Li ZH, et al. Efficacy of heated humidified high-flow nasal cannula in preterm infants aged less than 32 weeks after ventilator weaning. Zhongguo Dang Dai Er Ke Za Zhi. 2016;18:488-91. 2016 |
NBs 26-31 weeks + 6 days PCA |
161 |
Randomized controlled trial |
In preterm infants aged 29 weeks to 31 weeks + 6 days, HFNC has similar efficacy to CPAP after ventilatory weaning, whereas in those younger than 29 weeks, HFNC should be used with caution if selected as the first-line noninvasive respiratory support. |
Zong-Tai et al.,1616 Zong-Tai F, Zu-Ming Y, Dan-Feng G, Xiao-Lu Y. Clinical efficacy of heated humidified high-flow nasal cannula in preventing extubation failure in neonates: a meta analysis. Zhongguo Dang Dai Er Ke Za Zhi. 2015;17:1327-32. 2015 |
|
1040 |
Review and meta-analysis |
HFNC is safe and effective in preventing extubation failure in NBs. |
Liu,1313 Liu C. Efficacy and safety of heated humidified high-flow nasal cannula for prevention of extubation failure in neonates. Zhonghua Er Ke Za Zhi. 2014;52:271-6. 2014 |
|
255 |
Randomized controlled trial |
HFNC seems to have similar efficacy and safety as CPAP when applied immediately after extubation to prevent extubation failure. |
Daish et al.,1717 Daish H, Badurdeen S. Heated humidified high-flow nasal cannula versus nasal continuous positive airway pressure for post extubation ventilatory support in neonates: a meta-analysis. J Matern Fetal Neonatal Med. 2014;27:S208. 2014 |
|
726 |
Systematic review and meta-analysis |
There is no significant difference in extubation failure rate in extubated NBs with transition to HFNC compared with those extubated with transition to CPAP. |
Collins et al.,1414 Collins CL, Holberton JR, Barfield C, Davis PG. A randomized controlled trial to compare heated humidified high-flow nasal cannulae with nasal continuous positive airway pressure post extubation in premature infants. J Pediatr. 2013;162:949-54. 2013 |
NBs < 32 weeks PCA |
132 |
Randomized trial |
HFNC and CPAP result in equal extubation failure rate in NBs < 32 weeks of PCA. |
Manley et al.,1212 Manley BJ, Owen LS, Doyle LW, Andersen CC, Cartwright DW, Pritchard MA, et al. High-flow nasal cannulae in very preterm infants after extubation. N Engl J Med. 2013;369:1425-33. 2013 |
NBs < 32 weeks PCA |
303 |
Randomized controlled study |
HFNC is safe and not inferior to CPAP after the extubation of NBs < 32 weeks of PCA and causes less nasal trauma. |