Document Detail


High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized, controlled trial.
MedLine Citation:
PMID:  12231488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Observational studies of high-frequency oscillatory ventilation in adults with the acute respiratory distress syndrome have demonstrated improvements in oxygenation. We designed a multicenter, randomized, controlled trial comparing the safety and effectiveness of high-frequency oscillatory ventilation with conventional ventilation in adults with acute respiratory distress syndrome; 148 adults with acute respiratory distress syndrome (Pa(O2)/fraction of inspired oxygen <or= 200 mm Hg on 10 or more cm H2O positive end-expiratory pressure) were randomized to high-frequency oscillatory ventilation (n = 75) or conventional ventilation (n = 73). Applied mean airway pressure was significantly higher in the high-frequency oscillation group compared with the conventional ventilation group throughout the first 72 hours (p = 0.0001). The high-frequency oscillation group showed early (less than 16 hours) improvement in Pa(O2)/fraction of inspired oxygen compared with the conventional ventilation group (p = 0.008); however, this difference did not persist beyond 24 hours. Oxygenation index decreased similarly over the first 72 hours in both groups. Thirty-day mortality was 37% in the high-frequency oscillation group and was 52% in the conventional ventilation group (p = 0.102). The percentage of patients alive without mechanical ventilation at Day 30 was 36% and 31% in the high-frequency oscillation and conventional ventilation groups, respectively (p = 0.686). There were no significant differences in hemodynamic variables, oxygenation failure, ventilation failure, barotraumas, or mucus plugging between treatment groups. We conclude that high-frequency oscillation is a safe and effective mode of ventilation for the treatment of acute respiratory distress syndrome in adults.
Authors:
Stephen Derdak; Sangeeta Mehta; Thomas E Stewart; Terry Smith; Mark Rogers; Timothy G Buchman; Brian Carlin; Stuart Lowson; John Granton;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  166     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-16     Completed Date:  2002-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  801-8     Citation Subset:  AIM; IM    
Affiliation:
Pulmonary/Critical Care Medicine, Wilford Hall Medical Center, San Antonio, Texas 78236, USA. sderdak@mac.com
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MeSH Terms
Descriptor/Qualifier:
APACHE
Acute Disease
Adolescent
Adult
Aged
Female
Hemodynamics
High-Frequency Ventilation*
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Oxygen / blood
Prospective Studies
Respiration, Artificial
Respiratory Distress Syndrome, Adult / mortality,  physiopathology,  therapy*
Respiratory Function Tests
Safety
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2002 Sep 15;166(6):786-7   [PMID:  12231483 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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