Table1_Use of NHFOV vs. NIPPV for the respiratory support of preterm newborns after extubation: A meta-analysis.docx

ObjectivesThis meta-analysis evaluated and compared the efficacy and safety of noninvasive high-frequency oscillatory ventilation (NHFOV) and nasal intermittent positive-pressure ventilation (NIPPV) for preterm newborns after extubation.
MethodsWe searched the PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang and VIP databases from inception to August 28, 2022. Randomized controlled trials (RCTs) that evaluated and compared the efficacy and safety of NHFOV and NIPPV in newborns were included in the review and meta-analysis, which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.
ResultsEight studies involving 1,603 patients were included. Compared with NIPPV, NHFOV could reduce the reintubation rates (RR = 0.68, 95% CI 0.53, 0.86, P = 0.002). Subgroup analysis showed that the significant difference was found in reintubation rates within 72 h (RR = 0.48, 95% CI 0.32, 0.73, P = 0.0005). NHFOV also could decrease the duration of non-invasive ventilation (standard mean difference (SMD) = −1.52, 95% CI −2.58, −0.45, P = 0.005). However, all included studies had a high risk of bias, and the overall quality of the evidence of the outcomes was low or very low.
ConclusionIn our study, compared with NIPPV, NHFOV seems to reduce the reintubation rates without increasing adverse outcomes. Nevertheless, definite recommendations cannot be made based on the quality of the published evidence.

研究目的：本项荟萃分析旨在评估并比较无创高频振荡通气（noninvasive high-frequency oscillatory ventilation, NHFOV）与鼻间歇正压通气（nasal intermittent positive-pressure ventilation, NIPPV）用于早产儿拔管后的疗效与安全性。
研究方法：本研究检索了PubMed、Cochrane图书馆、EMBASE、Web of Science、中国知网（CNKI）、万方数据知识服务平台及维普数据库，检索时限自建库起始至2022年8月28日。纳入评估并比较新生儿应用NHFOV与NIPPV的疗效及安全性的随机对照试验（randomized controlled trial, RCT），本研究遵循系统评价与荟萃分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）报告规范开展。
研究结果：最终纳入8项研究，共涉及1603例受试者。与NIPPV相比，NHFOV可降低再插管率（相对风险RR=0.68，95%置信区间CI：0.53~0.86，P=0.002）。亚组分析显示，72小时内再插管率的差异具有统计学意义（RR=0.48，95%CI：0.32~0.73，P=0.0005）。此外，NHFOV还可缩短无创通气时长（标准化均数差SMD=-1.52，95%CI：-2.58~-0.45，P=0.005）。但所有纳入研究均存在较高偏倚风险，各项结局指标的证据整体质量为低或极低质量。
研究结论：本研究显示，与NIPPV相比，NHFOV似乎可降低再插管率且未增加不良结局发生风险。然而，基于现有证据的质量水平，尚无法给出明确的临床推荐建议。