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 (rScO(2)) compared to nasal continous positive airway pressure (nCPAP). Study Design A prospective, randomized, monocentric, open-label, noninferiority crossover trial. Newborns of gestational age (GA) >= 33 weeks exhibiting persistent respiratory distress after 10 minutes of life were treated with nHFPV and nCPAP, in succession and in random order. The primary endpoint was the mean rScO(2), as revealed by near-infrared spectroscopy (NIRS). Results Forty-nine newborns were randomized; the mean GA and birth weight was 36.4 +/- 1.9 weeks and 2718 +/- 497 g. The mean rScO(2)difference during the last 5 minutes of each ventilation mode (nHFPV minus nCPAP) was -0.7 +/- 5.4% (95% confidence interval (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.