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High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity

Alice H Johnson1, Janet L Peacock, Anne Greenough

  • 1Department of Child Health, St. George's Hospital Medical School, London, United Kingdom.

The New England Journal of Medicine
|August 30, 2002
PubMed

Insights

High-frequency oscillatory ventilation and conventional ventilation show similar outcomes for very preterm infants. Early respiratory support with either method did not significantly reduce mortality or chronic lung disease in this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care
  • Clinical Trials

Background:

  • Uncertainty exists regarding the comparative safety and efficacy of high-frequency oscillatory ventilation (HFOV) versus conventional ventilation (CV) for respiratory support in very preterm infants.
  • A multicenter trial was initiated to evaluate if early HFOV intervention could decrease mortality and chronic lung disease in newborns with gestational age ≤28 weeks.

Purpose of the Study:

  • To compare the effectiveness of early high-frequency oscillatory ventilation against conventional ventilation in reducing mortality and chronic lung disease in very preterm infants.
  • To assess secondary outcomes including treatment failure, serious brain injury, and air leak.

Main Methods:

  • A randomized controlled trial involving preterm infants with gestational ages from 23 to 28 weeks.
  • Infants were assigned to either HFOV or CV within one hour of birth, with stratification by center and gestational age (23-25 weeks or 26-28 weeks).

Main Results:

  • The composite outcome of death or chronic lung disease occurred in 66% of infants receiving HFOV and 68% receiving CV (RR 0.98; 95% CI 0.89-1.08).
  • No significant differences were observed between HFOV and CV groups for the primary outcome, secondary outcomes, treatment failure, serious brain injury, or air leak.

Conclusions:

  • Early use of high-frequency oscillatory ventilation and conventional ventilation yields comparable results for the initial treatment of respiratory issues in very preterm infants.
  • Further follow-up studies are necessary to ascertain the long-term effects of these ventilation strategies.
Abstract

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