Comparison of Treatment Outcomes of High-Flow Nasal Cannula and Nasal Continuous Positive Airway Pressure in Preterm Neonates with Respiratory Distress Syndrome in the NICU of Shahid Sadoughi Hospital in Yazd

Abstract

Background: Neonatal respiratory distress syndrome (RDS) is a common and urgent condition in newborns, caused by a lack of surfactant production and secretion. This study aimed to compare two non-invasive methods, nasal continuous positive airway pressure (nCPAP) and highflow nasal cannula (HFNC), for managing RDS. Methods: The study was conducted in the Neonatal Intensive Care Unit (NICU) of Shahid Sadoughi Hospital between 2020 and 2021 and included 49 premature neonates (with gestation ≤34 weeks and birth weight ≤2,000 g) diagnosed with RDS. The neonates were randomly assigned to either the HFNC group (n = 24) or the nCPAP group (n = 25). Results: No significant differences in demographic features were observed between the two groups. The HFNC group had lower rates of intubation, shorter hospitalization duration, and less need for full nutritional support and oxygen therapy compared to the nCPAP group, but these differences were not statistically significant. Additionally, there were no significant differences in complications such as traumatic nasal injury, apnea, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), pneumothorax, pulmonary hemorrhage, and mortality between the two groups. Conclusion: The results of this study suggest that both HFNC and nCPAP are equally effective in treating premature neonates with RDS, with no significant differences in clinical outcomes. Given the cost-effectiveness of HFNC, medical staff expertise, and equipment accessibility, this approach could be considered a viable alternative to nCPAP.