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In newborns with respiratory distress, high flow is inferior to CPAP
  1. Stacy Wightman,
  2. Joyce O'Shea
  1. Royal Hospital for Children Glasgow, Glasgow, UK
  1. Correspondence to Dr Stacy Wightman, Royal Hospital for Children Glasgow, Glasgow G51 4TF, UK; stacy.wightman{at}

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Review ofManley BJ, Arnolda GRB, Wright IMR, et al. Nasal high-flow therapy for newborn infants in special care nurseries. N Engl J Med 2019;380:2031–2040.

Study question

Study design: An unblinded, multicentre, randomised non-inferiority trial.

Allocation: Computer-generated block randomisation sequence with random-sized blocks.

Setting: Nine Australian non-tertiary neonatal centres

Patients: 754 neonates <24 hours of age, ≥31 weeks of gestation, weighing ≥ 1200g who required non-invasive ventilatory support.

Intervention: Patients were randomised to receive either high-flow (HF) therapy or continuous positive airway pressure (CPAP) . Exclusion criteria included pre-randomisation CPAP for ≥ 2 hours, previous endotracheal intubation, a major congenital abnormality or clinician discretion.

Primary outcome: …

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  • Contributors The abstract was written by SW. The commentary was written by both SW and JOS. Both authors reviewed the final article.

  • Provenance and peer review Not commissioned; externally peer reviewed.