Background: Respiratory Distress Syndrome (RDS) is a leading cause of respiratory failure in preterm infants, primarily resulting from surfactant deficiency and alveolar collapse. Approximately 15–20% of affected children require respiratory support. Despite advances in antenatal care and non-invasive ventilation that have reduced mortality and complications, the optimal mode of respiratory support remains uncertain. Nasal Continuous Positive Airway Pressure (NCPAP) and High-Flow Nasal Cannula (HFNC) are among the most widely used non-invasive methods for managing RDS—NCPAP enhances lung expansion and oxygenation, while HFNC offers greater comfort and ease of application. Given the ongoing debate over their relative efficacy and safety, this study aimed to systematically review and compare HFNC and NCPAP as initial respiratory support strategies in preterm infants with RDS. Methods: This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive literature search of PubMed, Web of Science, and Scopus was performed to identify studies published between 2015... Continue Reading