Summary of findings for the main comparison. NIPPV versus NCPAP (by population).
| NIPPV versus NCPAP (by population) | ||||||
| Patient or population: preterm infants Setting: neonatal intensive care units Intervention: NIPPV Comparison: NCPAP | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with NCPAP | Risk with NIPPV | |||||
| Respiratory failure | Study population | RR 0.62 (0.47 to 0.82) | 876 (9 RCTs) | Moderatea | Risk of bias: unblinded intervention Meets optimal information size (OIS) (N = 377) |
|
| 251 per 1000 | 155 per 1000 (120 to 200) | |||||
| Moderate | ||||||
| 175 per 1000 | 109 per 1000 (84 to 140) | |||||
| Need for intubation | Study population | RR 0.79 (0.64 to 0.97) | 766 (8 RCTs) | Moderatea | Risk of bias: unblinded intervention Does not meet OIS (N = 838) |
|
| 300 per 1000 | 237 per 1000 (192 to 291) | |||||
| Moderate | ||||||
| 175 per 1000 | 138 per 1000 (112 to 170) | |||||
| Pneumothorax | Study population | RR 0.69 (0.35 to 1.34) | 876 (9 RCTs) | Lowa,b | Risk of bias: unblinded intervention Imprecision: wide confidence intervals | |
| 43 per 1000 | 29 per 1000 (15 to 57) | |||||
| Moderate | ||||||
| 44 per 1000 | 30 per 1000 (15 to 58) | |||||
| Severe intraventricular hemorrhage (grade III/IV) | Study population | RR 1.26 (0.53 to 3.01) | 430 (4 RCTs) | Very lowa,b | Risk of bias: unblinded intervention Imprecision: extremely wide confidence intervals | |
| 37 per 1000 | 46 per 1000 (19 to 110) | |||||
| Moderate | ||||||
| 49 per 1000 | 61 per 1000 (26 to 147) | |||||
| Chronic lung disease | Study population | RR 0.67 (0.47 to 0.94) | 727 (8 RCTs) | Moderatea | Risk of bias: unblinded intervention Does not meet OIS (N = 1250) |
|
| 179 per 1000 | 120 per 1000 (84 to 168) | |||||
| Moderate | ||||||
| 170 per 1000 | 114 per 1000 (80 to 160) | |||||
| Mortality during study period | Study population | RR 0.77 (0.51 to 1.17) | 876 (9 RCTs) | Lowa,b | Risk of bias: unblinded intervention Imprecision: wide confidence intervals | |
| 89 per 1000 | 69 per 1000 (46 to 105) | |||||
| Low | ||||||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Moderate | ||||||
| 26 per 1000 | 20 per 1000 (13 to 30) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomized controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
aUnblinded intervention.
bImprecision: wide confidence intervals.