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Published on: February 9, 2022
High-frequency oscillatory ventilation with volume guarantee in infants: a systematic review
Wanjiao Liu1,2, Haifeng Zong1, Jin Jiang2
1Departments of Neonatology, Women and Children's Medical Center, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong Province, China.
Background:
This systematic review was designed to assess the efficacy and safety of high-frequency oscillatory ventilation (HFOV) combined with volume guarantee (VG) in infants compared with HFOV alone.
Methods:
We searched for electronic databases to find studies using HFOV-VG or HFOV for respiratory support in infants from the database creation to October 20, 2024. Two evaluators independently screened the literature, extracted data, and evaluated quality. Meta-analysis was performed using Rev man 5.3 software on survival-free BPD at grades 2 and 3 (SF-BPD), the incidence of BPD, mortality, duration of invasive ventilation, length of hospital stays, and complications in both groups.
Results:
The review included 11 studies (three randomized controlled trials, one non-randomized controlled trial, and seven observational studies) with 785 participants. Data analysis showed that HFOV-VG could increase SF-BPD in preterm infants (OR 3.15, 95%CI 1.66-5.98) without reducing the overall incidence of BPD compared with HFOV alone. HFOV-VG may offer advantages in shortening the duration of MV and total hospital stay, potentially reducing mortality and the incidence of air leak syndrome.
Conclusions Existing:
Studies showed that HFOV-VG had certain advantages in improving oxygenation and stable ventilation to protect neonatal lungs. HFOV-VG could increase SF-BPD in preterm infants with GA < 32 weeks without reducing the overall incidence of BPD compared with HFOV alone.
Impact:
Existing evidence suggested that HFOV-VG ventilation strategies could increase SF-BPD in preterm infants with GA < 32 weeks without reducing the overall incidence of BPD compared with HFOV alone. HFOV-VG ventilation strategy has certain advantages in improving oxygenation and stable ventilation to protect neonatal lungs. The effects of HFOV-VG vs. HFOV in neonates remain to be further validated by additional large sample, multicenter RCTs.
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