- Title
- Cost-effectiveness of Nasal High Flow versus CPAP for newborn infants in special-care nurseries
- Creator
- Huang, Li; Manley, Brett J.; Arnolda, Gaston R. B.; Owen, Louise S.; Wright, Ian M. R.; Foster, Jann P.; Davis, Peter G.; Buckmaster, Adam G.; Dalziel, Kim M.
- Relation
- Pediatrics Vol. 148, Issue 2, no. e2020020438
- Publisher Link
- http://dx.doi.org/10.1542/peds.2020-020438
- Publisher
- American Academy of Pediatrics
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Treating respiratory distress in newborns is expensive. We compared the cost-effectiveness of 2 common noninvasive therapies, nasal continuous positive airway pressure (CPAP) and nasal high-flow (nHF), for newborn infants cared for in nontertiary special care nurseries. Methods: The economic evaluation was planned alongside a randomized control trial conducted in 9 Australian special care nurseries. Costs were considered from a hospital perspective until infants were 12 months of age. A total of 754 infants with respiratory distress, born ≥31 weeks’ gestation and with birth weight ≥1200 g, <24 hours old, requiring noninvasive respiratory support and/or supplemental oxygen for >1 hour were recruited during 2015–2017. Inpatient costing records were obtained for 753 infants, of whom 676 were included in the per-protocol analysis. Two scenarios were considered: (1) CPAP versus nHF, with infants in the nHF group having “rescue” CPAP backup available (trial scenario); and (2) CPAP versus nHF, as sole primary support (hypothetical scenario). Effectiveness outcomes were rate of endotracheal intubation and transfer to a tertiary-level NICU. Results: As sole primary support, CPAP is more effective and on average cheaper, and thus is superior. However, nHF with back-up CPAP produced equivalent cost and effectiveness results, and there is no reason to make a decision between the 2 treatments on the basis of the cost or effectiveness outcomes. Conclusions: Nontertiary special care nurseries choosing to use only 1 of the modes should choose CPAP. In units with both modes available, using nHF as first-line therapy may be acceptable if there is back-up CPAP.
- Subject
- newborn; special care nurseries; continuous positive airway pressure (CPAP); effectiveness
- Identifier
- http://hdl.handle.net/1959.13/1472449
- Identifier
- uon:48837
- Identifier
- ISSN:0031-4005
- Language
- eng
- Reviewed
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