Effect of Nasal Continuous Positive Airway Pressure vs Heated Humidified High-Flow Nasal Cannula on Feeding Intolerance in Preterm Infants With Respiratory Distress Syndrome

作者：Francesco Cresi, Elena Maggiora, Gianluca Lista, Carlo Dani, S Borgione, Elena Spada, Mattia Ferroglio, Enrico Bertino, Alessandra Coscia, ENTARES Study Group, Michela Fiora, Sara Colombo, Chiara Peila, Mattia Luciano, Fabio Meneghin, Sara Gatto, Enrica Lupo, Serena N Elia, Martina Ciarcià, Fabio Mosca, Anna Orsi, Domenica Mercadante, Matilde Amatruda, Barbara Tomasini, Sara Cecchi, Pamela Liuzzo Lasagna, Stefano Martinelli, Laura Ilardi, A. Proto, Giovanni Vento, Simonetta Costa, Francesca Paola Fusco, Daniele Farina, Maria Francesca Campagnoli, Tatiana Boetti, Elena Boano, Andrea Sannia, C. De Maio, Eleonora Murizasco, Francesco Raimondi, Letizia Capasso, Serena Salomè, Massimo Agosti, Laura Morlacchi, Simona Perniciaro, Nicola Laforgia, Mariella Baldassarre, Manuela Capozza, Mauro Stronati, Elisa Civardi, Francesca Garofoli, Luca Maggio, Luigi Corvaglia · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.23052 · 被引用次数：18 · 研究领域：Neonatal Respiratory Health Research、Infant Nutrition and Health、Clinical Nutrition and Gastroenterology

Importance: Respiratory distress syndrome and feeding intolerance are common conditions that are often associated with preterm infants. Showing similar efficacy, nasal continuous positive airway pressure (NCPAP) and heated humidified high-flow nasal cannula (HHHFNC) are the most widespread noninvasive respiratory support (NRS) in neonatal intensive care units, but their effect on feeding intolerance is unknown. Objective: To evaluate the effect of NCPAP vs HHHFNC on high-risk preterm infants with respiratory distress syndrome. Design, Setting, and Participants: This multicenter randomized clinical trial involved infants who were born in 1 of 13 neonatal intensive care units in Italy between November 1, 2018, and June 30, 2021. Preterm infants with a gestational age of 25 to 29 weeks, who were suitable for enteral feeding and who proved to be medically stable on NRS for at least 48 hours were enrolled in the study within the first week of life and randomized to receive either NCPAP or HHHFNC. Statistical analysis was performed according to the intention-to-treat approach. Intervention: NCPAP or HHHFNC. Main Outcomes and Measures: The primary outcome was the time to full enteral feeding (FEF), defined as an enteral intake of 150 mL/kg per day. Secondary outcomes were the median daily increment of enteral feeding, signs of feeding intolerance, effectiveness of the assigned NRS, peripheral oxygen saturation (SpO2)-fraction of inspired oxygen (FIO2) ratio at changes of NRS, and gr...