Document Detail


Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data.
MedLine Citation:
PMID:  20569978     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Population and study design heterogeneity has confounded previous meta-analyses, leading to uncertainty about effectiveness and safety of elective high-frequency oscillatory ventilation (HFOV) in preterm infants. We assessed effectiveness of elective HFOV versus conventional ventilation in this group. METHODS: We did a systematic review and meta-analysis of individual patients' data from 3229 participants in ten randomised controlled trials, with the primary outcomes of death or bronchopulmonary dysplasia at 36 weeks' postmenstrual age, death or severe adverse neurological event, or any of these outcomes. FINDINGS: For infants ventilated with HFOV, the relative risk of death or bronchopulmonary dysplasia at 36 weeks' postmenstrual age was 0.95 (95% CI 0.88-1.03), of death or severe adverse neurological event 1.00 (0.88-1.13), or any of these outcomes 0.98 (0.91-1.05). No subgroup of infants (eg, gestational age, birthweight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids) benefited more or less from HFOV. Ventilator type or ventilation strategy did not change the overall treatment effect. INTERPRETATION: HFOV seems equally effective to conventional ventilation in preterm infants. Our results do not support selection of preterm infants for HFOV on the basis of gestational age, birthweight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids. FUNDING: Nestlé Belgium, Belgian Red Cross, and Dräger International.
Authors:
Filip Cools; Lisa M Askie; Martin Offringa; Jeanette M Asselin; Sandra A Calvert; Sherry E Courtney; Carlo Dani; David J Durand; Dale R Gerstmann; David J Henderson-Smart; Neil Marlow; Janet L Peacock; J Jane Pillow; Roger F Soll; Ulrich H Thome; Patrick Truffert; Michael D Schreiber; Patrick Van Reempts; Valentina Vendettuoli; Giovanni Vento;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-5-28
Journal Detail:
Title:  Lancet     Volume:  -     ISSN:  1474-547X     ISO Abbreviation:  -     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-6-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Neonatal Intensive Care Unit, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
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