High-frequency oscillation for acute respiratory distress syndrome
Duncan Young, Sarah E Lamb, Sanjoy Shah, Iain MacKenzie, William Tunnicliffe, Ranjit Lall, Kathy Rowan, Brian H Cuthbertson, OSCAR Study Group, Duncan Young, Deborah Ashby, Kathy Rowan, Steve Drage, Tim Walsh, Barry Williams, Heather House, Brian Cuthbertson, Sallie Lamb, Ranjit Lall, Christopher McCabe, David Torgerson, David Menon, Peter Nightingale, Duncan Young, Peter Macnaughton, Brian Cuthbertson, Catherine Plowright, Bill Tunnicliffe, Steve Drage, Geoff Bellingan, Sanjoy Shah, Andrew Padkin, Bernard Foex, Paul Hughes, Khalid Elfituri, Frank McAuley, Chris Cairns, Jonathan Paddle, Huw Maddock, Nick Coleman, Andy Kong, Robert Lewis, Martin Bewsher, Andreas Brodbeck, David Pogson, Martin Clark, Stephen Mousdale, Andrew Bodenham, Rebecca Cusack, Mark Bellamy, Henry Paw, Jason Cupitt, David Higgins, Cait Searl, Judith Wright, Duncan Young, Sarah E Lamb, Sanjoy Shah, Iain MacKenzie, William Tunnicliffe, Ranjit Lall, Kathy Rowan, Brian H Cuthbertson, OSCAR Study Group, Duncan Young, Deborah Ashby, Kathy Rowan, Steve Drage, Tim Walsh, Barry Williams, Heather House, Brian Cuthbertson, Sallie Lamb, Ranjit Lall, Christopher McCabe, David Torgerson, David Menon, Peter Nightingale, Duncan Young, Peter Macnaughton, Brian Cuthbertson, Catherine Plowright, Bill Tunnicliffe, Steve Drage, Geoff Bellingan, Sanjoy Shah, Andrew Padkin, Bernard Foex, Paul Hughes, Khalid Elfituri, Frank McAuley, Chris Cairns, Jonathan Paddle, Huw Maddock, Nick Coleman, Andy Kong, Robert Lewis, Martin Bewsher, Andreas Brodbeck, David Pogson, Martin Clark, Stephen Mousdale, Andrew Bodenham, Rebecca Cusack, Mark Bellamy, Henry Paw, Jason Cupitt, David Higgins, Cait Searl, Judith Wright
Abstract
Background: Patients with the acute respiratory distress syndrome (ARDS) require mechanical ventilation to maintain arterial oxygenation, but this treatment may produce secondary lung injury. High-frequency oscillatory ventilation (HFOV) may reduce this secondary damage.
Methods: In a multicenter study, we randomly assigned adults requiring mechanical ventilation for ARDS to undergo either HFOV with a Novalung R100 ventilator (Metran) or usual ventilatory care. All the patients had a ratio of the partial pressure of arterial oxygen (PaO) to the fraction of inspired oxygen (FiO) of 200 mm Hg (26.7 kPa) or less and an expected duration of ventilation of at least 2 days. The primary outcome was all-cause mortality 30 days after randomization.
Results: There was no significant between-group difference in the primary outcome, which occurred in 166 of 398 patients (41.7%) in the HFOV group and 163 of 397 patients (41.1%) in the conventional-ventilation group (P=0.85 by the chi-square test). After adjustment for study center, sex, score on the Acute Physiology and Chronic Health Evaluation (APACHE) II, and the initial PaO:FiO ratio, the odds ratio for survival in the conventional-ventilation group was 1.03 (95% confidence interval, 0.75 to 1.40; P=0.87 by logistic regression).
Conclusions: The use of HFOV had no significant effect on 30-day mortality in patients undergoing mechanical ventilation for ARDS. (Funded by the National Institute for Health Research Health Technology Assessment Programme; OSCAR Current Controlled Trials number, ISRCTN10416500.).
Source: PubMed