Scolaris Content Display Scolaris Content Display

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figures and Tables -
Figure 2

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.1 Respiratory failure.
Figures and Tables -
Figure 3

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.1 Respiratory failure.

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.2 Need for intubation.
Figures and Tables -
Figure 4

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.2 Need for intubation.

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.3 Mortality during study period.
Figures and Tables -
Figure 5

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.3 Mortality during study period.

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.4 Chronic lung disease.
Figures and Tables -
Figure 6

Forest plot of comparison: 1 NIPPV vs NCPAP (by population), outcome: 1.4 Chronic lung disease.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 1 Respiratory failure.
Figures and Tables -
Analysis 1.1

Comparison 1 NIPPV vs NCPAP (by population), Outcome 1 Respiratory failure.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 2 Need for intubation.
Figures and Tables -
Analysis 1.2

Comparison 1 NIPPV vs NCPAP (by population), Outcome 2 Need for intubation.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 3 Mortality during study period.
Figures and Tables -
Analysis 1.3

Comparison 1 NIPPV vs NCPAP (by population), Outcome 3 Mortality during study period.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 4 Chronic lung disease.
Figures and Tables -
Analysis 1.4

Comparison 1 NIPPV vs NCPAP (by population), Outcome 4 Chronic lung disease.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 5 Pneumothorax.
Figures and Tables -
Analysis 1.5

Comparison 1 NIPPV vs NCPAP (by population), Outcome 5 Pneumothorax.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 6 Intraventricular hemorrhage (all grades).
Figures and Tables -
Analysis 1.6

Comparison 1 NIPPV vs NCPAP (by population), Outcome 6 Intraventricular hemorrhage (all grades).

Comparison 1 NIPPV vs NCPAP (by population), Outcome 7 Severe intraventricular hemorrhage (grade III/IV).
Figures and Tables -
Analysis 1.7

Comparison 1 NIPPV vs NCPAP (by population), Outcome 7 Severe intraventricular hemorrhage (grade III/IV).

Comparison 1 NIPPV vs NCPAP (by population), Outcome 8 Necrotizing enterocolitis (≥ Bell's stage 2).
Figures and Tables -
Analysis 1.8

Comparison 1 NIPPV vs NCPAP (by population), Outcome 8 Necrotizing enterocolitis (≥ Bell's stage 2).

Comparison 1 NIPPV vs NCPAP (by population), Outcome 9 Sepsis.
Figures and Tables -
Analysis 1.9

Comparison 1 NIPPV vs NCPAP (by population), Outcome 9 Sepsis.

Comparison 1 NIPPV vs NCPAP (by population), Outcome 10 Retinopathy of prematurity (≥ stage 3).
Figures and Tables -
Analysis 1.10

Comparison 1 NIPPV vs NCPAP (by population), Outcome 10 Retinopathy of prematurity (≥ stage 3).

Comparison 1 NIPPV vs NCPAP (by population), Outcome 11 Local upper airway injury.
Figures and Tables -
Analysis 1.11

Comparison 1 NIPPV vs NCPAP (by population), Outcome 11 Local upper airway injury.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 1 Respiratory failure.
Figures and Tables -
Analysis 2.1

Comparison 2 NIPPV vs NCPAP (by device), Outcome 1 Respiratory failure.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 2 Need for intubation.
Figures and Tables -
Analysis 2.2

Comparison 2 NIPPV vs NCPAP (by device), Outcome 2 Need for intubation.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 3 Mortality.
Figures and Tables -
Analysis 2.3

Comparison 2 NIPPV vs NCPAP (by device), Outcome 3 Mortality.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 4 Chronic lung disease.
Figures and Tables -
Analysis 2.4

Comparison 2 NIPPV vs NCPAP (by device), Outcome 4 Chronic lung disease.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 5 Pneumothorax.
Figures and Tables -
Analysis 2.5

Comparison 2 NIPPV vs NCPAP (by device), Outcome 5 Pneumothorax.

Comparison 2 NIPPV vs NCPAP (by device), Outcome 6 Severe intraventricular hemorrhage (grade III/IV).
Figures and Tables -
Analysis 2.6

Comparison 2 NIPPV vs NCPAP (by device), Outcome 6 Severe intraventricular hemorrhage (grade III/IV).

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 1 Respiratory failure.
Figures and Tables -
Analysis 3.1

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 1 Respiratory failure.

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 2 Need for intubation.
Figures and Tables -
Analysis 3.2

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 2 Need for intubation.

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 3 Mortality.
Figures and Tables -
Analysis 3.3

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 3 Mortality.

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 4 Chronic lung disease.
Figures and Tables -
Analysis 3.4

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 4 Chronic lung disease.

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 5 Pneumothorax.
Figures and Tables -
Analysis 3.5

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 5 Pneumothorax.

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 6 Severe intraventricular hemorrhage (grade III/IV).
Figures and Tables -
Analysis 3.6

Comparison 3 NIPPV vs NCPAP (by synchronization), Outcome 6 Severe intraventricular hemorrhage (grade III/IV).

Comparison 4 NIPPV vs NCPAP high‐quality studies only (by device), Outcome 1 Respiratory failure (high‐quality studies).
Figures and Tables -
Analysis 4.1

Comparison 4 NIPPV vs NCPAP high‐quality studies only (by device), Outcome 1 Respiratory failure (high‐quality studies).

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.

Figures and Tables -
Summary of findings for the main comparison. NIPPV versus NCPAP (by population)
Comparison 1. NIPPV vs NCPAP (by population)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Respiratory failure Show forest plot

10

1060

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.51, 0.82]

1.1 Surfactant (via INSURE) before enrollment

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.37 [0.15, 0.90]

1.2 No surfactant treatment before enrollment

6

774

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.56, 0.97]

1.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.24, 0.91]

2 Need for intubation Show forest plot

9

950

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.64, 0.94]

2.1 Surfactant (via INSURE) before enrollment

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.12, 3.57]

2.2 No surfactant treatment before enrollment

6

774

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.69, 1.02]

2.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.24, 0.91]

3 Mortality during study period Show forest plot

10

1061

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.51, 1.15]

3.1 Surfactant (via INSURE) before enrollment

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.07, 16.76]

3.2 No surfactant treatment before enrollment

6

775

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.52, 1.30]

3.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.21, 1.42]

4 Chronic lung disease Show forest plot

9

899

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.58, 1.06]

4.1 Surfactant (via INSURE) before enrollment

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.29, 1.00]

4.2 No surfactant treatment before enrollment

5

627

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.64, 1.32]

4.3 Mixed population (re: surfactant treatment) before enrollment

2

122

Risk Ratio (M‐H, Fixed, 95% CI)

0.39 [0.08, 1.91]

5 Pneumothorax Show forest plot

10

1061

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.42, 1.48]

5.1 Surfactant (via INSURE) before enrollment

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.45 [0.07, 2.94]

5.2 No surfactant treatment before enrollment

6

775

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [0.52, 2.91]

5.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.13, 1.41]

6 Intraventricular hemorrhage (all grades) Show forest plot

5

370

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.54, 1.16]

6.1 Surfactant (via INSURE) before enrollment

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 3.92]

6.2 No surfactant treatment before enrollment

3

270

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.56, 1.22]

6.3 Mixed population (re: surfactant treatment) before enrollment

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Severe intraventricular hemorrhage (grade III/IV) Show forest plot

4

430

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [0.53, 3.01]

7.1 Surfactant (via INSURE) before enrollment

1

110

Risk Ratio (M‐H, Fixed, 95% CI)

5.37 [0.26, 109.35]

7.2 No surfactant treatment before enrollment

3

320

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.39, 2.59]

7.3 Mixed population (re: surfactant treatment) before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Necrotizing enterocolitis (≥ Bell's stage 2) Show forest plot

7

718

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.34, 1.31]

8.1 Surfactant (via INSURE) before enrollment

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.10, 2.82]

8.2 No surfactant treatment before enrollment

4

492

Risk Ratio (M‐H, Fixed, 95% CI)

0.58 [0.25, 1.33]

8.3 Mixed population (re: surfactant treatment) before enrollment

1

76

Risk Ratio (M‐H, Fixed, 95% CI)

1.58 [0.28, 8.93]

9 Sepsis Show forest plot

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.36, 1.70]

9.1 Surfactant (via INSURE) before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 No surfactant treatment before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.36, 1.70]

10 Retinopathy of prematurity (≥ stage 3) Show forest plot

2

245

Risk Ratio (M‐H, Fixed, 95% CI)

1.50 [0.65, 3.44]

10.1 Surfactant (via INSURE) before enrollment

1

110

Risk Ratio (M‐H, Fixed, 95% CI)

3.22 [0.13, 77.41]

10.2 No surfactant treatment before enrollment

1

135

Risk Ratio (M‐H, Fixed, 95% CI)

1.39 [0.58, 3.30]

10.3 Mixed population (re: surfactant treatment) before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Local upper airway injury Show forest plot

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.11 [0.03, 0.41]

11.1 Surfactant (via INSURE) before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 No surfactant treatment before enrollment

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 Mixed population (re: surfactant treatment) before enrollment

2

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.11 [0.03, 0.41]

Figures and Tables -
Comparison 1. NIPPV vs NCPAP (by population)
Comparison 2. NIPPV vs NCPAP (by device)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Respiratory failure Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Ventilator‐generated NIPPV

6

606

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.47, 0.86]

1.2 Bilevel NIPPV

2

160

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.44, 2.27]

1.3 Mixed devices

2

294

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.38, 0.93]

2 Need for intubation Show forest plot

10

Risk Difference (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Ventilator‐generated NIPPV

6

606

Risk Difference (M‐H, Fixed, 95% CI)

‐0.08 [‐0.14, ‐0.02]

2.2 Bilevel NIPPV

2

160

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.10, 0.10]

2.3 Mixed devices

2

294

Risk Difference (M‐H, Fixed, 95% CI)

‐0.11 [‐0.20, ‐0.02]

3 Mortality Show forest plot

9

977

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.51, 1.15]

3.1 Ventilator‐generated NIPPV

5

522

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.52, 1.23]

3.2 Bilevel NIPPV

2

160

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 4.08]

3.3 Mixed devices

2

295

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.21, 2.83]

4 Chronic lung disease Show forest plot

9

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Ventilator‐generated NIPPV

5

457

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.47, 1.15]

4.2 Bilevel NIPPV

2

160

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.24, 2.13]

4.3 Mixed devices

2

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.54, 1.32]

5 Pneumothorax Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Ventilator‐generated NIPPV

6

606

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.21, 1.11]

5.2 Bilevel NIPPV

2

160

Risk Ratio (M‐H, Fixed, 95% CI)

2.5 [0.49, 12.67]

5.3 Mixed devices

2

295

Risk Ratio (M‐H, Fixed, 95% CI)

1.42 [0.28, 7.29]

6 Severe intraventricular hemorrhage (grade III/IV) Show forest plot

3

346

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [0.51, 3.62]

6.1 Ventilator‐generated NIPPV

2

236

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.35, 3.04]

6.2 Mixed devices

1

110

Risk Ratio (M‐H, Fixed, 95% CI)

5.37 [0.26, 109.35]

Figures and Tables -
Comparison 2. NIPPV vs NCPAP (by device)
Comparison 3. NIPPV vs NCPAP (by synchronization)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Respiratory failure Show forest plot

10

1060

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.51, 0.81]

1.1 Nonsynchronized NIPPV

5

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.60 [0.44, 0.83]

1.2 Synchronized NIPPV

4

304

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.41, 1.02]

1.3 Mixed methods

1

184

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.44, 1.22]

2 Need for intubation Show forest plot

10

1060

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.61, 0.87]

2.1 Nonsynchronized NIPPV

5

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.60, 0.92]

2.2 Synchronized NIPPV

4

304

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.42, 1.06]

2.3 Mixed methods

1

184

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.44, 1.22]

3 Mortality Show forest plot

9

977

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.51, 1.15]

3.1 Synchronized NIPPV

3

220

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.03, 2.19]

3.2 Nonsynchronized NIPPV

5

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.54, 1.27]

3.3 Mixed methods

1

185

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.16, 3.09]

4 Chronic lung disease Show forest plot

9

899

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.58, 1.06]

4.1 Nonsynchronized NIPPV

4

423

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.51, 1.08]

4.2 Synchronized NIPPV

4

304

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.18, 1.01]

4.3 Mixed methods

1

172

Risk Ratio (M‐H, Fixed, 95% CI)

1.38 [0.70, 2.72]

5 Pneumothorax Show forest plot

10

1061

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.42, 1.48]

5.1 Nonsynchronized NIPPV

5

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.24, 1.40]

5.2 Synchronized NIPPV

4

304

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.30, 2.43]

5.3 Mixed methods

1

185

Risk Ratio (M‐H, Fixed, 95% CI)

4.74 [0.23, 97.39]

6 Severe intraventricular hemorrhage (grade III/IV) Show forest plot

3

346

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [0.51, 3.62]

6.1 Synchronized NIPPV

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 Nonsynchronized NIPPV

3

346

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [0.51, 3.62]

Figures and Tables -
Comparison 3. NIPPV vs NCPAP (by synchronization)
Comparison 4. NIPPV vs NCPAP high‐quality studies only (by device)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Respiratory failure (high‐quality studies) Show forest plot

8

902

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.50, 0.82]

1.1 Ventilator‐generated NIPPV

4

448

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.45, 0.85]

1.2 Bilevel NIPPV

2

160

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.44, 2.27]

1.3 Mixed devices

2

294

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.38, 0.93]

Figures and Tables -
Comparison 4. NIPPV vs NCPAP high‐quality studies only (by device)