{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T03:12:09Z","timestamp":1770347529365,"version":"3.49.0"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Our aim is to compare the efficacy and safety of high-flow nasal cannula (HFNC) against those of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV) after extubation in preterm infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This prospective, randomized, noninferiority trial was conducted in 6 tertiary NICUs. Infants born at &amp;lt;34 weeks who needed noninvasive ventilation after extubation were enrolled. We randomly assigned infants to an HFNC group when HFNC was used or to an NCPAP\/NIPPV group when NCPAP or NIPPV was used. The primary outcome was treatment failure within 7 days after extubation. We then examined clinical aspects of treatment failure with HFNC use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>In total, 176 and 196 infants were assigned to the HFNC and NCPAP\/NIPPV groups, respectively. The HFNC group showed a significantly higher rate of treatment failure than that of the NCPAP\/NIPPV group, with treatment failure occurring in 54 infants (31%) compared with 31 infants (16%) in the NCPAP\/NIPPV group (risk difference, 14.9 percentage points; 95% confidence interval, 6.2\u201323.2). Histologic chorioamnionitis (P = .02), treated patent ductus arteriosus (P = .001), and corrected gestational age at the start of treatment (P = .007) were factors independently related to treatment failure with HFNC use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>We found HFNC revealed a significantly higher rate of treatment failure than NCPAP or NIPPV after extubation in preterm infants. The independent factors associated with treatment failure with HFNC use were histologic chorioamnionitis, treated patent ductus arteriosus, and a younger corrected gestational age at the start of treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2020-1101","type":"journal-article","created":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T13:38:43Z","timestamp":1605793123000},"source":"Crossref","is-referenced-by-count":27,"title":["Randomized Controlled Trial of High-Flow Nasal Cannula in Preterm Infants After Extubation"],"prefix":"10.1542","volume":"146","author":[{"given":"Atsushi","family":"Uchiyama","sequence":"first","affiliation":[{"name":"Department of Pediatrics and"},{"name":"Department of Neonatal Medicine, Maternal and Perinatal Center, Tokyo Women\u2019s Medical University, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaoru","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tokyo Metropolitan Children\u2019s Medical Center, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tokyo Metropolitan Children\u2019s Medical Center, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuntaro","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saitama Medical Center and Saitama Medical University, Saitama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Motojima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saitama Medical Center and Saitama Medical University, Saitama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Namba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saitama Medical Center and Saitama Medical University, Saitama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiko","family":"Nagano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, School of Medicine, Nihon University, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayo","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, School of Medicine, Nihon University, Tokyo, Japan;"},{"name":"Department of Pediatrics, Iino Women\u2019s and Children\u2019s Hospital, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Kayama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, School of Medicine, Nihon University, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Nagaoka Red Cross Hospital, Niigata, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Soeno","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Nagaoka Red Cross Hospital, Niigata, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Numata","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Nagaoka Red Cross Hospital, Niigata, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyo","family":"Suenaga","sequence":"additional","affiliation":[{"name":"Department of Neonatal Medicine, Maternal and Perinatal Center, Tokyo Women\u2019s Medical University, Tokyo, Japan;"},{"name":"Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Neonatal Medicine, Maternal and Perinatal Center, Tokyo Women\u2019s Medical University, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidehiko","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideshi","family":"Fujinaga","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Furuya","sequence":"additional","affiliation":[{"name":"Basic Clinical Science and Public Health, School of Medicine, Tokai University, Kanagawa, 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