Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data
| Autor: | 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, Wei, Lei |
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| Přispěvatelé: | Neonatology, APH - Amsterdam Public Health, Other Research, PreVILIG Collaboration |
| Rok vydání: | 2010 |
| Předmět: |
Pediatrics
medicine.medical_specialty medicine.medical_treatment Population High-Frequency Ventilation Infant Premature Diseases law.invention Positive-Pressure Respiration Randomized controlled trial law medicine Humans Pediatrics Perinatology and Child Health education Bronchopulmonary Dysplasia Medicine(all) Mechanical ventilation Respiratory Distress Syndrome Newborn education.field_of_study high-frequency oscillatory business.industry High-frequency ventilation Infant Newborn Postmenstrual Age Preterm infants Gestational age General Medicine medicine.disease conventional ventilation Bronchopulmonary dysplasia Relative risk Human medicine business Infant Premature |
| Zdroj: | Lancet, 375(9731), 2082-2091. Elsevier Limited The lancet : international edition |
| ISSN: | 0140-6736 |
| DOI: | 10.1016/s0140-6736(10)60278-4 |
| Popis: | Summary 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 Nestle Belgium, Belgian Red Cross, and Drager International. |
| Databáze: | OpenAIRE |
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