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. 2020 Apr 17;2020(4):CD013231. doi: 10.1002/14651858.CD013231.pub2

Osman 2019.

Methods This a randomized controlled trial to assess efficacy of early CPAP, in reducing the severity and duration of TTN compared with administration of free‐flow oxygen.
Participants 64 late preterm/term neonates, delivered by cesarean section and presenting with respiratory distress shortly after birth.
Interventions Patients were randomized to receive 20 m of early CPAP, delivered using a T‐piece‐based infant resuscitator (Neopuff) via a face mask, or to receive free‐flow oxygen.
Outcomes Primary outcome measures include assessment of the duration and degree of respiratory distress.
Secondary outcome measures include the need for admission to NICU secondary to respiratory distress of more than 6 h, plasma BNP post‐Neopuff levels, the need of mechanical ventilation, the incidence of pulmonary air leaks, the duration of hospitalization and mortality.
Notes clinicaltrials.gov/ct2/show/nct01859533 
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk The newborns were randomly assigned into 2 groups using computer‐generated randomization.
Allocation concealment (selection bias) Unclear risk No information provided.
Blinding of participants and personnel (performance bias) 
 All outcomes High risk The assigned intervention could not be blinded.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk No information provided.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk All outcome data were reported.
Selective reporting (reporting bias) High risk 1 of the secondary outcomes became primary outcome and there is no information on 2 secondary outcomes.
Other bias Low risk Appears free of other bias.

CPAP = continuous positive airway pressure
 g = grams
 GA = gestational age
 m = minutes
 NCPAP = nasal continuous positive airway pressure
 NHFPV = nasal high frequency percussive ventilation
 NIMV = nasal intermittent mandatory ventilation
 NICU = neonatal intensive care unit
 TTN = transient tachypnea of the newborn