{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:06:26Z","timestamp":1771430786030,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heated humidified high flow (HHHFNC) and nasal intermittent positive pressure ventilation (NIPPV) delivered by cannula with long and narrow tubing (CLNT) are increasingly used in preterm infants for providing noninvasive respiratory support, due to their high comfort level and minimal nasal trauma. Despite their widespread use, no randomized controlled trial has been conducted so far.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determine whether HHHFNC is non\u2010inferior to CLNT\u2010NIPPV in providing respiratory support for preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>An unblinded, randomized controlled, non\u2010inferiority multicenter trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Preterm infants randomized to either HHHFNC or CLNT\u2010NIPPV. Infants born &gt;\u200928 weeks of gestation were eligible to enter the study either as primary treatment after birth or post\u2010extubation. Infants born \u2264\u200928 weeks of gestation were only eligible post\u2010extubation. The primary outcome was treatment failure within 7 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and thirty infants were enrolled in the study; 65 in each group. Most (82%) were &gt;\u200928 weeks, and primary treatment (73%). HHHFNC was non\u2010inferior to CLNT\u2010NIPPV in the primary outcome which occurred in 12.3% compared to 23.0% of the infants, respectively (risk difference (RD) \u221210.77%, 95% CI of RD \u221223.7 to 2.22 [within the non\u2010inferiority margin],\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.168). HHHFNC was associated with significantly less nasal trauma compared to CLNT\u2010NIPPV but with longer time on the allocated respiratory support. No significant differences were found between the groups in secondary respiratory and neonatal outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study of preterm infants mostly &gt;\u200928 weeks of gestation, HHHFNC was non\u2010inferior to CLNT\u2010NIPPV in providing respiratory support, and caused less nasal trauma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71167","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T09:00:19Z","timestamp":1750150819000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HHHFNC Versus NIPPV Delivered by Long Narrow Cannula in Preterm Infants: Randomized Noninferiority Trial"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-4754","authenticated-orcid":false,"given":"Ayala","family":"Gover","sequence":"first","affiliation":[{"name":"Technion Institute of Technology Ruth and Bruce Rappaport Faculty of Medicine Haifa Israel"},{"name":"Neonatal Intensive Care Unit Bnai\u2010Zion Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-5257","authenticated-orcid":false,"given":"Tatiana","family":"Smolkin","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Tzafon Medical Center Poryia Israel"},{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Molad","sequence":"additional","affiliation":[{"name":"Technion Institute of Technology Ruth and Bruce Rappaport Faculty of Medicine Haifa Israel"},{"name":"Neonatal Intensive Care Unit Carmel Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0140-4985","authenticated-orcid":false,"given":"Karen","family":"Lavie\u2010Nevo","sequence":"additional","affiliation":[{"name":"Technion Institute of Technology Ruth and Bruce Rappaport Faculty of Medicine Haifa Israel"},{"name":"Neonatal Intensive Care Unit Carmel Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adir","family":"Iofe","sequence":"additional","affiliation":[{"name":"Technion Institute of Technology Ruth and Bruce Rappaport Faculty of Medicine Haifa Israel"},{"name":"Neonatal Intensive Care Unit Bnai\u2010Zion Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha","family":"Zoabi\u2010Safadi","sequence":"additional","affiliation":[{"name":"Technion Institute of Technology Ruth and Bruce Rappaport Faculty of Medicine Haifa 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