High flow nasal cannula for respiratory support in term infants (Review)
Journal article
Dopper, Alex, Steele, Michael, Bogossian, Fiona and Hough, Judith. (2023). High flow nasal cannula for respiratory support in term infants (Review). Cochrane Database of Systematic Reviews. 2023(8), p. Article CD011010. https://doi.org/10.1002/14651858.CD011010.pub2
Authors | Dopper, Alex, Steele, Michael, Bogossian, Fiona and Hough, Judith |
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Abstract | Background Objectives Search methods Selection criteria Data collection and analysis Main results Four studies contributed to our comparison of high flow nasal cannula (HFNC) oxygen therapy versus continuous positive airway pressure (CPAP) for respiratory support in term infants. The outcome of death was reported in two studies (439 infants) but there were no events in either group. HFNC may have little to no effect on treatment failure, but the evidence is very uncertain (RR 0.98, 95% CI 0.47 to 2.04; 3 trials, 452 infants; very low‐certainty evidence). The outcome of chronic lung disease (need for supplemental oxygen at 28 days of life) was reported in one study (375 participants) but there were no events in either group. HFNC may have little to no effect on the duration of respiratory support (any form of non‐invasive respiratory support with or without supplemental oxygen), but the evidence is very uncertain (MD 0.17 days, 95% CI ‐0.28 to 0.61; 4 trials, 530 infants; very low‐certainty evidence). HFNC likely results in little to no difference in the length of stay at the intensive care unit (ICU) (MD 0.90 days, 95% CI ‐0.31 to 2.12; 3 trials, 452 infants; moderate‐certainty evidence). HFNC may reduce the incidence of nasal trauma (RR 0.16, 95% CI 0.04 to 0.66; 1 trial, 78 infants; very low‐certainty evidence) and abdominal overdistension (RR 0.22, 95% CI 0.07 to 0.71; 1 trial, 78 infants; very low‐certainty evidence), but the evidence is very uncertain. Two studies contributed to our analysis of HFNC versus low flow nasal cannula oxygen therapy (LFNC) (supplemental oxygen up to a maximum flow rate of 2 L/min). The outcome of death was reported in both studies (95 infants) but there were no events in either group. The evidence suggests that HFNC may reduce treatment failure slightly (RR 0.44, 95% CI 0.21 to 0.92; 2 trials, 95 infants; low‐certainty evidence). Neither study reported results for the outcome of chronic lung disease (need for supplemental oxygen at 28 days of life). HFNC may have little to no effect on the duration of respiratory support (MD ‐0.07 days, 95% CI ‐0.83 to 0.69; 1 trial, 74 infants; very low‐certainty evidence), length of stay at the ICU (MD 0.49 days, 95% CI ‐0.83 to 1.81; 1 trial, 74 infants; very low‐certainty evidence), or hospital length of stay (MD ‐0.60 days, 95% CI ‐2.07 to 0.86; 2 trials, 95 infants; very low‐certainty evidence), but the evidence is very uncertain. Adverse events was an outcome reported in both studies (95 infants) but there were no events in either group. The risk of bias across outcomes was generally low, although there were some concerns of bias. The certainty of evidence across outcomes ranged from moderate to very low, downgraded due to risk of bias, imprecision, indirectness, and inconsistency. Authors' conclusions When compared with LFNC, HFNC may reduce treatment failure slightly. HFNC may have little to no effect on the duration of respiratory support, length of stay at the ICU, or hospital length of stay, but the evidence is very uncertain. There is insufficient evidence to enable the formulation of evidence‐based guidelines on the use of HFNC for respiratory support in term infants. Larger, methodologically robust trials are required to further evaluate the possible health benefits or harms of HFNC in this patient population. |
Year | 2023 |
Journal | Cochrane Database of Systematic Reviews |
Journal citation | 2023 (8), p. Article CD011010 |
Publisher | John Wiley & Sons Ltd |
ISSN | 1465-1858 |
Digital Object Identifier (DOI) | https://doi.org/10.1002/14651858.CD011010.pub2 |
PubMed ID | 37542728 |
Scopus EID | 2-s2.0-85166598216 |
PubMed Central ID | PMC10401649 |
Open access | Open access |
Page range | 1-60 |
Publisher's version | License All rights reserved File Access Level Open |
Output status | Published |
Publication dates | |
Online | 04 Aug 2023 |
Publication process dates | |
Deposited | 24 Nov 2023 |
https://acuresearchbank.acu.edu.au/item/90008/high-flow-nasal-cannula-for-respiratory-support-in-term-infants-review
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Dopper_2023_High_flow_nasal_cannula_for_respiratory.pdf | |
License: All rights reserved | |
File access level: Open |
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