High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome

Wunsch, Hannah; Mapstone, James

doi:10.1002/14651858.cd004085.pub2

Cited by 29 publications

(14 citation statements)

References 17 publications

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“…28 We included six additional trials of high frequency oscillation and unpublished data provided by primary investigators, which generated additional statistical power and more precise estimates of treatment effects.…”

Section: Findings In Relation To Other Studiesmentioning

confidence: 99%

“…[25][26][27] An earlier systematic review of randomised controlled trials found only two small trials and could not draw definitive conclusions about the effect of high frequency oscillation on mortality. 28 Additional studies have subsequently become available. Furthermore, in the context of current 29 30 and future pandemics, there is a pressing need for evidence on the effects of potentially life saving interventions for patients with ARDS.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis

Sud

Friedrich

et al. 2010

BMJ

222

128

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Objective To determine clinical and physiological effects of high frequency oscillation compared with conventional ventilation in patients with acute lung injury/acute respiratory distress syndrome (ARDS). Design Systematic review and meta-analysis. Data sources Electronic databases to March 2010, conference proceedings, bibliographies, and primary investigators. Study selection Randomised controlled trials of high frequency oscillation compared with conventional ventilation in adults or children with acute lung injury/ ARDS. Data selection Three authors independently extracted data on clinical, physiological, and safety outcomes according to a predefined protocol. We contacted investigators of all included studies to clarify methods and obtain additional data. Analyses used random effects models. Results Eight randomised controlled trials (n=419 patients) were included; almost all patients had ARDS. Methodological quality was good. The ratio of partial pressure of oxygen to inspired fraction of oxygen at 24, 48, and 72 hours was 16-24% higher in patients receiving high frequency oscillation. There were no significant differences in oxygenation index because mean airway pressure rose by 22-33% in patients receiving high frequency oscillation (P≤0.01). In patients randomised to high frequency oscillation, mortality was significantly reduced (risk ratio 0.77, 95% confidence interval 0.61 to 0.98, P=0.03; six trials, 365 patients, 160 deaths), and treatment failure (refractory hypoxaemia, hypercapnoea, hypotension, or barotrauma) resulting in discontinuation of assigned therapy was less likely (0.67, 0.46 to 0.99, P=0.04; five trials, 337 patients, 73 events). Other risks were similar. There was substantial heterogeneity between trials for physiological (I 2 =21-95%) but not clinical (I 2 =0%) outcomes. Pooled results were based on few events for most clinical outcomes. Conclusion High frequency oscillation might improve survival and is unlikely to cause harm. As ongoing large multicentre trials will not be completed for several years, these data help clinicians who currently use or are considering this technique for patients with ARDS.

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Section: Findings In Relation To Other Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis

Sud

Friedrich

et al. 2010

BMJ

222

128

View full text Add to dashboard Cite

show abstract

“…18 Currently, no clear evidence indicates whether high frequency ventilation reduces mortality or long term morbidity in patients with acute lung injury or respiratory distress syndrome.…”

Section: Other Ventilatory Techniquesmentioning

confidence: 99%

Acute respiratory distress syndrome

Leaver

Evans

2007

BMJ

100

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“…There has been increasing interest in the role of high frequency oscillatory ventilation (HFOV) in adults with ARDS over the last few years, following anecdotal reports of improved oxygenation and the benefits seen in paediatrics [24]. Consideration was given to HFOV in this patient, as oscillation may potentially have made removal of the sand easier due to the mechanical effects of this mode of ventilation.…”

Section: Discussionmentioning

confidence: 99%

Sand aspiration: a case report and review of the radiological features and management

Appelboam¹,

Williams²,

Duffy

2010

Anaesthesia

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High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome

Abstract: There is not enough evidence to conclude whether high-frequency ventilation reduces mortality or long-term morbidity in patients with ALI or ARDS; further trials are needed.

Cited by 29 publications

References 17 publications

High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis

High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis

Acute respiratory distress syndrome

Sand aspiration: a case report and review of the radiological features and management

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