A prospective, randomized, multicenter trial of high-frequency oscillatory ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome receiving surfactant

Rettwitz-Volk, Werner; Veldman, Alex; Roth, Bernhardt; Vierzig, Anne; Kachel, W.; Varnholt, Verena; Schlößer, Rolf; Loewenich, V von

doi:10.1016/s0022-3476(98)70440-8

Cited by 105 publications

(50 citation statements)

References 14 publications

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“…9,18 -24 Four met the inclusion criteria and were published in full. 9,18 -20 There were two recently presented abstracts 23,24 that were not included in the meta-analyses because it was not possible to assess the methodology and the outcomes according to the a priori protocol. The HIFO study 21 was excluded from the analysis because HFOV was used for rescue rather than electively.…”

Section: Resultsmentioning

confidence: 99%

“…This was considered to be primarily a rescue rather than an elective use of HFOV. The other three studies were by Ramanathan et al, 22 Rettwitz-Volk et al, 23 and Lambert et al 24 The study by Ramanathan was excluded from the main analysis because there was a mandatory crossover from HFOV to CV at 96 hours of age. This was felt to impair the ability to evaluate respiratory outcomes in the same way as assessed by the other studies in which crossover was allowed but not mandatory.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, because IVH is primarily a disorder occurring in the first few days of life, this outcome is still of interest and is discussed below. The results of trials by Rettwitz-Volk 23 and by Lambert et al 24 were excluded from the meta-analysis because they had not been peer reviewed and it was difficult to assess the methodology and outcomes from the abstracts.…”

Section: Discussionmentioning

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: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…21 Six randomized controlled trials have evaluated patient-triggered ventilation versus intermittent mandatory ventilation; two of these studies used the Infant Star Ventilator. 6 One unexpected finding in our study was a significant difference among centers in ventilator days, CPAP days, and days in oxygen. Although the prospective nature of this trial suggested an approach to weaning from mechanical ventilation, the time to extubation varied greatly.…”

Section: Discussionmentioning

confidence: 58%

The Sy-Fi Study: A Randomized Prospective Trial of Synchronized Intermittent Mandatory Ventilation Versus a High-Frequency Flow Interrupter in Infants Less Than 1000 G

2003

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“…Two of these studies 9,10 reported lower BPD incidence among infants randomized to high-frequency ventilation (HFV) when compared to IMV, while Wiswell et al 11 had to stop their study because of increase in IVH or PVL among infants randomized to HFJV. Among the eight HFV trials [12][13][14][15][16][17][18][19] published between 1998 and 2003, when surfactant therapy and SIMV were commonly used, only two studies reported a decrease in BPD 13 with HFOV use, and two studies 14,18 reported an increase in air leaks with HIFI use. Finally, three trials compared elective use of HFV in RDS.…”

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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A prospective, randomized, multicenter trial of high-frequency oscillatory ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome receiving surfactant

Cited by 105 publications

References 14 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

The Sy-Fi Study: A Randomized Prospective Trial of Synchronized Intermittent Mandatory Ventilation Versus a High-Frequency Flow Interrupter in Infants Less Than 1000 G

Lung protective ventilatory strategies in very low birth weight infants

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