Heated, Humidified High-flow Nasal (HHHFN) Cannula vs Nasal Continuous Positive Airway Pressure in Respiratory Distress in Premature Neonates

Newborn babies who have difficulty breathing may need breathing support to help them receive enough oxygen. Two commonly used methods are heated, humidified high-flow nasal cannula (HHFNC), which delivers warmed, moist air and oxygen through small tubes in the nose, and nasal continuous positive airway pressure (nCPAP), which helps keep the lungs open by delivering air and oxygen under gentle pressure through a nasal mask or tubes. This study will compare these two methods in newborn babies born at 28 weeks of pregnancy or later who develop breathing difficulties within the first 24 hours after birth. The study will be conducted in the neonatal intensive care unit at PAF Hospital Islamabad and will include 100 newborn babies. Participants will be randomly assigned to receive either HHFNC or nCPAP as their initial breathing support. The main purpose is to compare how often each method fails to provide adequate breathing support within the first 72 hours, requiring a change to another form of breathing support or insertion of a breathing tube for mechanical ventilation. The study will also assess other outcomes, including nasal injury, survival until hospital discharge, need for surfactant treatment, duration of breathing support and oxygen therapy, time to achieve full feeding, intestinal complications, and length of hospital stay. The findings may help improve understanding of the effectiveness and safety of these two breathing support methods in newborn babies with breathing difficulties.