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Elective high-frequency oscillatory ventilation in preterm infants: a meta-analysis of individual patient data

Elective high-frequency oscillatory ventilation in preterm infants: a meta-analysis of individual patient data
Elective high-frequency oscillatory ventilation in preterm infants: a meta-analysis of individual patient data
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, birth weight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids.
Funding Nestlé Belgium, Belgian Red Cross, and Dräger International
0140-6736
Cools, Filip
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Askie, Lisa
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Asselin Offriga, J.M. Martin
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Calvert, S.A.
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Courtney, S.E.
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Dani, C.
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Durand, D.J.
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Gerstmann, D.R.
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Henderson-Smith, D.J.
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Marlow, N.
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Peacock, J.L.
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Pillow, J.J.
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Soll, R.F.
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Thome, U.H.
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Truffert, P.
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Schreiber, M.D.
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Reempts Van, P.
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Ventettuoli, V.
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Vento, G.
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Cools, Filip
40a197cc-575f-4597-abac-9816406f8083
Askie, Lisa
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Asselin Offriga, J.M. Martin
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Calvert, S.A.
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Courtney, S.E.
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Dani, C.
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Durand, D.J.
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Gerstmann, D.R.
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Henderson-Smith, D.J.
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Marlow, N.
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Peacock, J.L.
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Pillow, J.J.
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Soll, R.F.
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Thome, U.H.
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Truffert, P.
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Schreiber, M.D.
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Reempts Van, P.
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Ventettuoli, V.
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Vento, G.
7e5dce96-b056-4e64-85b9-a2f6166fba14

Cools, Filip, Askie, Lisa, Asselin Offriga, J.M. Martin, Calvert, S.A., Courtney, S.E., Dani, C., Durand, D.J., Gerstmann, D.R., Henderson-Smith, D.J., Marlow, N., Peacock, J.L., Pillow, J.J., Soll, R.F., Thome, U.H., Truffert, P., Schreiber, M.D., Reempts Van, P., Ventettuoli, V. and Vento, G. (2010) Elective high-frequency oscillatory ventilation in preterm infants: a meta-analysis of individual patient data. Lancet. (doi:10.1016/S0140-6736(10)60278-4). (In Press)

Record type: Article

Abstract

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, birth weight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids.
Funding Nestlé Belgium, Belgian Red Cross, and Dräger International

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More information

Accepted/In Press date: June 2010
Organisations: Community Clinical Sciences

Identifiers

Local EPrints ID: 155299
URI: http://eprints.soton.ac.uk/id/eprint/155299
ISSN: 0140-6736
PURE UUID: d22f7b7e-8943-4bba-9e18-d4c572bf1c29

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Date deposited: 27 May 2010 12:53
Last modified: 09 Jan 2022 07:06

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Contributors

Author: Filip Cools
Author: Lisa Askie
Author: J.M. Martin Asselin Offriga
Author: S.A. Calvert
Author: S.E. Courtney
Author: C. Dani
Author: D.J. Durand
Author: D.R. Gerstmann
Author: D.J. Henderson-Smith
Author: N. Marlow
Author: J.L. Peacock
Author: J.J. Pillow
Author: R.F. Soll
Author: U.H. Thome
Author: P. Truffert
Author: M.D. Schreiber
Author: P. Reempts Van
Author: V. Ventettuoli
Author: G. Vento

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