Clinical outcomes in infants who received NIV from 2010 to 2017 in England and Wales: comparison between those who received any HFNC versus those who had CPAP only
| All infants (n=45 862) | HFNC (n=26 936) | CPAP only (n=18 926) | aOR or median difference (95% CI) | |
| Dichotomous outcomes, n (%) | ||||
| BPD n=44 271* † | 15 472 (34.9) | 12 336 (47.0) | 3136 (17.4) | 2.98 (2.81 to 3.15)‡ |
| Death before discharge n=45 862† | 1598 (3.5) | 678 (2.5) | 920 (4.9) | 0.19 (0.17 to 0.22)‡ |
| BPD or death before discharge n=45 862† | 17 063 (37.2) | 13 008 (48.3) | 4055 (21.4) | 2.46 (2.33 to 2.60)‡ |
| Late-onset sepsis | 18 784 (41.0) | 13 234 (49.1) | 5550 (29.3) | 1.81 (1.72 to 1.90)‡ |
| NEC (confirmed) | 8111 (17.7) | 5670 (21.0) | 2441 (12.9) | 1.34 (1.26 to 1.43)‡ |
| NEC requiring surgery | 1479 (3.2) | 1065 (4.0) | 414 (2.2) | 1.19 (1.03 to 1.36) |
| PDA requiring surgery | 936 (2.0) | 751 (2.8) | 185 (1.0) | 2.08 (1.73 to 2.50)‡ |
| IVH (grade 3/4) | 2180 (4.7) | 1558 (5.8) | 622 (3.3) | 0.94 (0.84 to 1.06) |
| Periventricular leukomalacia | 1046 (2.3) | 715 (2.7) | 331 (1.7) | 1.24 (1.06 to 1.44) |
| ROP requiring treatment | 2372 (5.2) | 2032 (7.5) | 340 (1.8) | 1.73 (1.52 to 1.96)‡ |
| Pneumothorax | 1915 (4.2) | 1337 (5.0) | 578 (3.1) | 1.59 (1.41 to 1.78)‡ |
| Received postnatal steroids | 2869 (6.3) | 2400 (8.9) | 469 (2.5) | 1.93 (1.71 to 2.18)‡ |
| Continuous outcomes, median (IQR) | ||||
| Number of days of invasive ventilation* | 2 (0–6) | 3 (1–9) | 1 (0–3) | 0.0 (−2.1 to 2.1)‡ |
| Number of days of NIV* | 12 (4–36) | 24 (8–46) | 5 (2–13) | 6.3 (5.7 to 6.9)‡ |
| Number of days of respiratory support* | 22 (6–61) | 41 (11–77) | 7 (3–25) | 9.5 (9.1 to 9.9)‡ |
| Length of stay (days)* | 55 (40–80) | 66 (47–91) | 44 (34–59) | 8.7 (8.3 to 9.1)‡ |
Adjusted for gestational age <28 weeks, sex, birth weight z-score <−2, exposure to antenatal steroids, NMR-200 category, mechanical ventilation on day 1, year of admission.
*Excluded infants who died before 36 weeks’ corrected gestational age.
†Missing observations: BPD, 8; death before discharge, 17.
‡P<0.05 with Bonferroni correction.
aOR, adjusted OR; BPD, bronchopulmonary dysplasia; CPAP, continuous positive airway pressure; HFNC, high flow nasal cannula oxygen; IVH, intraventricular haemorrhage; NEC, necrotising enterocolitis; NIV, non-invasive ventilation; ROP, retinopathy of prematurity.