Cochrane: High-Frequency Oscillatory Ventilation Not Supported for ARDS
The systematic review, by Sachin Sud, Trillium Health Center, University of Toronto, Division of Critical Care, Department of Medicine, Canada, and colleauges, included 10 randomised controlled trials (RCTs) (1850 patients) that compared children and adults with moderate or severe ARDS who were treated using HFO compared with conventional mechanical ventilation. One trial was stopped early because of increased mortality among participants who were randomised to HFO compared to mechanical ventilation with low tidal volume and high positive end expiratory pressure, with HFO reserved only as a rescue therapy. Four trials reported ventilator industry funding. The reviewers highlighted the low quality of the evidence due to imprecision, inconsistency, indirectness and methodological limitations, with substantial between-trial statistical heterogeneity for clinical outcomes, including mortality.
Based on 8 trials (1779 patients) the review found no significant difference in hospital or 30-day mortality compared with conventional ventilation. The reviewers also found that the ability of the lungs to oxygenate blood, measured at 24 to 72 hours of ventilation after randomisation, was 18% to 26% better in participants receiving HFO. HFO had no effect on the length of time an artificial breathing machine was required. The risk of unwanted side effects, including low blood pressure or further injury to the lung due to high airway pressure, was not increased.
The review of HFO was first published in 2004 and was first updated in 2013. The cut-off point for published studies was December 2015.
Image credit: Wikimedia Commons
Published on : Tue, 19 Apr 2016
Print as PDF
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
Medos hemofilters pro are used for efficient and gentle hemofiltration during extracorporal circulation.Medos hemofilters pro do not need to be pre-flushed and can be used immediately. This guarantees a safe and quick hemofiltration.
NovaPort cannulas: The safe access to the vascular system. NovaPort® twin double lumen cannulas are specifically developed for veno-venous vascular access. NovaPort one single lumen cannulas are specifically developed for the percutaneous connection (KU)...
The HAMILTON-T1 combines for the first time the functionality of a fully featured intensive care unit ventilator with the compactness and ruggedness required for transport. This is why the HAMILTON-T1 enables you to provide optimal ventilation therapy...