Background In animal models nasal high frequency oscillatory ventilation appears to provide better lung development and less injury that means it could be protective against repeated need of conventional ventilation. In a randomised study we compared the clinical efficacy of nasal high frequency oscillatory ventilation (nHFOV) and nasal intermittent positive pressure ventilation (NIPPV) in prevention of repeated intubation in preterm infants with very low birth weight.

Methods 24 preterm infants with birth weight <1500 g on conventional mechanical ventilation (MV) were randomly assigned into two groups before extubation within 7 days of age. 12 infants with gestational age of 27.75 (2.41) weeks were treated with nHFOV and 12 infants with gestational age of 27.66 (1.66) wks were extubated to NIPPV for at least 72 hours. The primary study outcome was the repeated need for MV within 72 hours after primary extubation. The incidences of BPD at 36 weeks’ corrected age were compared in the groups as well. BPD was defined according to the NIH consensus definition in modification of Walsh et al. (2003).

Results Extubation failure rate after primary extubation was the same in the both groups – 41.67%. There was no difference in total duration of respiratory support between the groups. BPD developed in 2 infants (16.67%) in the nHFOV group and in 1 infant (8.33%) in the control group (p > 0.05).

Conclusions In this study nHFOV was not found to be more effective than NIPPV in prevention of primary extubation failure in preterm infants with very low birth weight.