{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:26:01Z","timestamp":1791476761857,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We reviewed using a high\u2010flow nasal cannula (<jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content>) as first\u2010line support for preterm neonates with, or at risk of, respiratory distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This rapid systematic review covered biomedical databases up to June 2017. We included randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) published in English. The reference lists of the studies and relevant reviews we included were also screened. We performed the study selection, data extraction, study quality assessment, meta\u2010analysis and quality of evidence assessment following the Grading of Recommendations Assessment, Development and Evaluation system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pooled results from six <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s covering 1227 neonates showed moderate\u2010quality evidence that <jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content> was associated with a higher rate of failure than nasal continuous positive airway pressure (<jats:styled-content style=\"fixed-case\">NCPAP<\/jats:styled-content>) in preterm neonates of at least 28\u00a0weeks of gestation, with a risk ratio of 1.57. Low\u2010quality evidence showed no significant differences between <jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NCPAP<\/jats:styled-content> in the need for intubation and bronchopulmonary dysplasia rate. <jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content> yielded a lower rate of nasal injury (risk ratio 0.50). When <jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content> failed, intubation was avoided in some neonates by switching them to <jats:styled-content style=\"fixed-case\">NCPAP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HFNC<\/jats:styled-content> had higher failure rates than <jats:styled-content style=\"fixed-case\">NCPAP<\/jats:styled-content> when used as first\u2010line support. Subsequently switching to <jats:styled-content style=\"fixed-case\">NCPAP<\/jats:styled-content> sometimes avoided intubation. Data on the most immature neonates were lacking.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14396","type":"journal-article","created":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T23:39:42Z","timestamp":1526081982000},"page":"1684-1696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Rapid systematic review shows that using a high\u2010flow nasal cannula is inferior to nasal continuous positive airway pressure as first\u2010line support in preterm neonates"],"prefix":"10.1111","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8703-2181","authenticated-orcid":false,"given":"Francesca","family":"Conte","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit San Giovanni Calibita Fatebenefratelli Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Orfeo","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit San Giovanni Calibita Fatebenefratelli Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Gizzi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Azienda Ospedaliera Regionale San Carlo Potenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Massenzi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit San Giovanni Calibita Fatebenefratelli Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Fasola","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine and Molecular Immunology National Research Council of Italy Palermo Italy"},{"name":"Department of Economic, Business and Statistical Sciences University of Palermo Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.04.007"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2016.01.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-310497"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2011.02070.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-309328"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13644"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12903"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2014.206"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304525"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12636"},{"key":"e_1_2_10_12_1","first-page":"CD005384","article-title":"Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants","volume":"12","author":"Lemyre B","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_13_1","first-page":"CD006405","article-title":"High flow nasal cannula for respiratory support in preterm infants","volume":"2","author":"Wilkinson D","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0738"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta20300"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.24"},{"key":"e_1_2_10_17_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462316000489"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-56"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_10_21_1","volume-title":"Review Manager (RevMan) Computer program, version 5.3","author":"The Cochrane Collaboration","year":"2014"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39490.551019.BE"},{"key":"e_1_2_10_24_1","volume-title":"GRADE handbook for grading quality of evidence and strength of recommendations","author":"Sch\u00fcnemann H","year":"2013"},{"key":"e_1_2_10_25_1","volume-title":"GRADE Working Group. 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