A multicenter randomized trial of high frequency oscillatory ventilation as compared with conventional mechanical ventilation in preterm infants with respiratory failure

Ogawa, Yutaka; Miyasaka, Katsuyuki; Kawano, Tsuyoshi; Imura, Souichi; Inukai, Kazuhisa; Okuyama, Kazuo; Oguchi, Kouki; Togari, Hajime; Nishida, Hiroshi; Mishina, Jun

doi:10.1016/0378-3782(93)90088-c

Cited by 158 publications

(75 citation statements)

References 11 publications

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“…However, caution is warranted interpreting this result because: 1) the treatment is not blinded and this could affect assessment of some outcomes; 2) except for one small trial 20 postneonatal survival, lung function, and neurodevelopment have not been reported from HVS trials; 3) the benefits and disadvantages have not been reported in infants born at different gestational ages or of different birth weights. Importantly, results from groups experienced in the use of HFOV may not be generalizable.…”

Section: Implications For Clinical Practicementioning

confidence: 98%

“…25 There were no significant differences in the rate of growth, incidence of respiratory tract infections, hospital readmission, retractions and episodes of wheezing, or in respiratory function tests. Twelve month follow-up of patients in the trial by Ogawa et al 20 showed persistence of abnormal fibrous or emphysematous shadows on chest radiography in 2 of the infants in the HFOV group and 4 in the CV group.…”

Section: Long-term Pulmonary Outcomesmentioning

confidence: 99%

“…One year follow-up in the trial by Ogawa et al 20 found 4 infants in each group (8.7% vs 9%) had delays in motor and/or mental development, although the method of neurologic assessment was not given. No follow-up results have been reported for the other trials.…”

Section: Neurodevelopmental Outcomes At Follow-upmentioning

confidence: 99%

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Elective High-frequency Oscillatory Ventilation Versus Conventional Ventilation in Preterm Infants With Pulmonary Dysfunction: Systematic Review and Meta-analyses

Bhuta

Henderson‐Smart

1997

Pediatrics

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ABSTRACT. Objectives. To systematically review the evidence to determine whether the routine use of highfrequency oscillatory ventilation (HFOV) as compared with conventional ventilation (CV) is beneficial or harmful in preterm infants requiring mechanical ventilation for pulmonary failure principally due to respiratory distress syndrome.Methods. All randomized controlled trials of elective HFOV versus CV in preterm infants <36 weeks' gestation with respiratory failure mainly attributable to respiratory distress syndrome were identified from the literature through a search of MEDLINE, EMBASE, Oxford database of Perinatal trials, and previous reviews including cross-references and abstracts. Meta-analyses using event rate ratios (ERR), event rate difference, and if significant, number needed-to-treat were calculated (95% confidence limits were used for all analyses). Two prespecified subgroup analyses were performed.Results. Four published trials 9,18 -20 were included. Meta-analyses revealed the following ERR (95% confidence intervals) for HFOV versus CV 19Conclusions. The overall meta-analysis is dominated by the HIFI study, 9 which was criticized for its methodology 11 and surfactant was not used. Subsequent studies, most of which used HVS and/or surfactant, have shown benefits in measures of CLD without an increase in rates of IVH. Caution is warranted in interpreting these results because: 1) the treatment is not blinded and this could affect some outcomes; 2) except for one small trial 20 postneonatal survival, lung function, and neurodevelopment have not been reported from HVS trials; and 3) the benefits and disadvantages have not been reported in infants born at different gestational ages or different birth weights. Importantly, results from groups experienced in the use of HFOV may not be readily generalizable. Pediatrics 1997;100(5). URL: http://www.pediatrics.org/ cgi/content/full/100/5/e6; meta-analyses, high-frequency ventilation, high-frequency oscillatory ventilation, chronic lung disease, preterm, neonatal ventilation, neonatal morbidity.

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Section: Implications For Clinical Practicementioning

confidence: 98%

Section: Long-term Pulmonary Outcomesmentioning

confidence: 99%

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Elective High-frequency Oscillatory Ventilation Versus Conventional Ventilation in Preterm Infants With Pulmonary Dysfunction: Systematic Review and Meta-analyses

Bhuta

Henderson‐Smart

1997

Pediatrics

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“…Nontidal ventilation using high-frequency oscillatory ventilation (HFOV), high-frequency flow interruption (HIFI) and high-frequency jet ventilation (HFJV) have all been studied in the management of RDS before and after surfactant therapy became available and in comparison with intermittent mandatory ventilation (IMV) as well as synchronized IMV (SIMV). 2 Among the six trials [3][4][5][6][7][8] published during the presurfactant era, Clark et al 6 reported a decrease in BPD with HFOV when compared to IMV (Table 1). However, the incidence of severe intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) was significantly higher in one of the HIFI trials published in 1989.…”

Section: Introductionmentioning

confidence: 99%

Lung protective ventilatory strategies in very low birth weight infants

Ramanathan

Sardesai

2008

J Perinatol

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Respiratory distress syndrome (RDS) is the most common respiratory diagnosis in preterm infants. Surfactant therapy and mechanical ventilation using conventional or high-frequency ventilation have been the standard of care in the management of RDS. Bronchopulmonary dysplasia (BPD) continues to remain as a major morbidity in very low birth weight infants despite these treatments. There is no significant difference in pulmonary outcome when an optimal lung volume strategy is used with conventional or high-frequency ventilation. Lung injury is directly related to the duration of invasive ventilation via the endotracheal tube. Studies using noninvasive ventilation, such as nasal continuous positive airway pressure and noninvasive positive pressure ventilation, have shown to decrease postextubation failures as well as a trend toward reduced risk of BPD. Lung protective ventilatory strategy may involve noninvasive ventilation as a primary therapy or following surfactant administration in very preterm infants with RDS. Initial steps in the management of preterm infants may also include sustained inflation to establish functional residual capacity, followed by noninvasive ventilation to minimize lung injury and subsequent development of BPD.

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“…9 Although all studies included preterm infants, the upper limit for birth weight and gestational age differed between the studies. Most studies focused on the very low birth weight infant; however, three studies included infants as large as 2000 g. 9,11,12 The age and randomization varied from less than 1 h 16,20 to 9 h of age.…”

Section: Elective Hfov Vs Conventional Ventilation (Cv)mentioning

confidence: 99%

The clinical impact of high frequency ventilation: review of the cochrane meta-analyses

Soll

2006

J Perinatol

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Experimental work in animal models suggests that ventilation strategies using high frequency oscillatory ventilation or high frequency jet ventilation hold great promise in the prevention of lung injury in preterm infants. However, clinical trials of either modality demonstrate little clinical benefit and there are possibilities of adverse effects, including increased risk of intraventricular hemorrhage and poor neurological development.

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A multicenter randomized trial of high frequency oscillatory ventilation as compared with conventional mechanical ventilation in preterm infants with respiratory failure

Cited by 158 publications

References 11 publications

Elective High-frequency Oscillatory Ventilation Versus Conventional Ventilation in Preterm Infants With Pulmonary Dysfunction: Systematic Review and Meta-analyses

Elective High-frequency Oscillatory Ventilation Versus Conventional Ventilation in Preterm Infants With Pulmonary Dysfunction: Systematic Review and Meta-analyses

Lung protective ventilatory strategies in very low birth weight infants

The clinical impact of high frequency ventilation: review of the cochrane meta-analyses

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