Nasal high-frequency percussive ventilation versus nasal continuous positive airway pressure in newborn infants respiratory distress: a cross over clinical trial.

OBJECTIVE To determine if nasal high-frequency percussive ventilation (nHFPV) to manage neonatal respiratory distress decreases the regional cerebral oxygen saturation (rScO2 ) compared to nasal CPAP. STUDY DESIGN A prospective, randomized, monocentric, open-label, non-inferiority crossover trial. Newborns of gestational age (GA) ≥ 33 weeks exhibiting persistent respiratory distress after 10 min of life were treated with nHFPV and nCPAP, in succession and in random order. The primary endpoint was the mean rScO2 , as revealed by near-infrared spectroscopy (NIRS). RESULTS Forty-nine newborns were randomized; the mean GA and birth weight were 36.4 ± 1.9 weeks and 2,718 ± 497 g. The mean rScO2 difference during the last 5 min of each ventilation mode (nHFPV minus nCPAP) was -0.7 ± 5.4% (95% CI -2.25; 0.95%). CONCLUSION In our study on newborns of GA ≥ 33 weeks treated for respiratory distress, cerebral oxygenation via nHFPV was not inferior to nCPAP. This article is protected by copyright. All rights reserved.