{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:11:01Z","timestamp":1769634661965,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The present study was conducted to compare the clinical efficacy of three noninvasive respiratory support strategies\u2014nasal continuous positive airway pressure (NCPAP), noninvasive positive pressure ventilation (NIPPV), and noninvasive high\u2010frequency oscillatory ventilation (NHFOV)\u2014in neonates with severe meconium aspiration syndrome (MAS) following extubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this multicenter randomized controlled trial, 170 neonates with severe MAS from three tertiary neonatal intensive care units in Southwest China (Jan 2025\u2013May 2025) were randomized to receive post\u2010extubation NCPAP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200956), NIPPV (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963), or NHFOV (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951). Primary outcomes were reintubation rate within 7 days and arterial blood gas parameters at 1, 12, and 24\u2009h post\u2010extubation. Secondary outcomes included ventilation duration, supplemental oxygen days, hospital stay, and complications including but not limited to nasal trauma, abdominal distension, among other predefined complications. The research protocol was prospectively registered in the Chinese Clinical Trial Registry (MR\u201050\u201024\u2010057272; registration date: December 28, 2024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>NHFOV demonstrated significantly lower reintubation rates compared to both NCPAP and NIPPV, while no difference was observed between NIPPV and NCPAP. NHFOV showed superior oxygenation with higher PaO\u2082 levels and lower PaCO\u2082 levels across all timepoints. Secondary outcomes favored NHFOV, including shorter durations of invasive ventilation, noninvasive ventilation, and hospital stay, alongside reduced complications (abdominal distension, nasal trauma). No significant differences were observed in BPD, air leaks, severe IVH, or NEC rates among groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NHFOV significantly reduces reintubation rates and improves gas exchange compared to NCPAP and NIPPV in severe MAS neonates, supporting its potential as the preferred post\u2010extubation respiratory support strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71388","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:44:10Z","timestamp":1762947850000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["NHFOV Versus CPAP and NIPPV for Post\u2010Extubation Support in Severe Meconium Aspiration Syndrome"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7705-0126","authenticated-orcid":false,"given":"Leilei","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Pediatrics Third Military Medical University Southwest Hospital Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xian","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Neonatology SongShan General Hospital Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanhuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neonatology Chongqing Jiulongpo People's Hospital Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Ai","sequence":"additional","affiliation":[{"name":"Department of Neonatology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2530-2043","authenticated-orcid":false,"given":"Juan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neonatology SongShan General Hospital Chongqing China"},{"name":"Department of Neonatology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases Chongqing 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