Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data

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

Research output: Contribution to journalArticle

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

Original languageEnglish
Pages (from-to)2082-2091
Number of pages10
JournalLancet
Volume375
Issue number9731
DOIs
Publication statusPublished - 2010

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High-Frequency Ventilation
Premature Infants
Ventilation
Meta-Analysis
Bronchopulmonary Dysplasia
Lung Diseases
Gestational Age
Adrenal Cortex Hormones
Red Cross
Pregnancy
Belgium
Mechanical Ventilators
Uncertainty
Randomized Controlled Trials
Safety
Population

ASJC Scopus subject areas

  • Medicine(all)

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Elective high-frequency oscillatory versus conventional ventilation in preterm infants : a systematic review and meta-analysis of individual patients' data. / Cools, Filip; Askie, Lisa M.; Offringa, Martin; Asselin, Jeanette M.; Calvert, Sandra A.; Courtney, Sherry E.; Dani, Carlo; Durand, David J.; Gerstmann, Dale R.; Henderson-Smart, David J.; Marlow, Neil; Peacock, Janet L.; Pillow, J. Jane; Soll, Roger F.; Thome, Ulrich H.; Truffert, Patrick; Schreiber, Michael D.; Van Reempts, Patrick; Vendettuoli, Valentina; Vento, Giovanni.

In: Lancet, Vol. 375, No. 9731, 2010, p. 2082-2091.

Research output: Contribution to journalArticle

Cools, F, Askie, LM, Offringa, M, Asselin, JM, Calvert, SA, Courtney, SE, Dani, C, Durand, DJ, Gerstmann, DR, Henderson-Smart, DJ, Marlow, N, Peacock, JL, Pillow, JJ, Soll, RF, Thome, UH, Truffert, P, Schreiber, MD, Van Reempts, P, Vendettuoli, V & Vento, G 2010, 'Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data', Lancet, vol. 375, no. 9731, pp. 2082-2091. https://doi.org/10.1016/S0140-6736(10)60278-4
Cools, Filip ; Askie, Lisa M. ; Offringa, Martin ; Asselin, Jeanette M. ; Calvert, Sandra A. ; Courtney, Sherry E. ; Dani, Carlo ; Durand, David J. ; Gerstmann, Dale R. ; Henderson-Smart, David J. ; Marlow, Neil ; Peacock, Janet L. ; Pillow, J. Jane ; Soll, Roger F. ; Thome, Ulrich H. ; Truffert, Patrick ; Schreiber, Michael D. ; Van Reempts, Patrick ; Vendettuoli, Valentina ; Vento, Giovanni. / Elective high-frequency oscillatory versus conventional ventilation in preterm infants : a systematic review and meta-analysis of individual patients' data. In: Lancet. 2010 ; Vol. 375, No. 9731. pp. 2082-2091.
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AU - Cools, Filip

AU - Askie, Lisa M.

AU - Offringa, Martin

AU - Asselin, Jeanette M.

AU - Calvert, Sandra A.

AU - Courtney, Sherry E.

AU - Dani, Carlo

AU - Durand, David J.

AU - Gerstmann, Dale R.

AU - Henderson-Smart, David J.

AU - Marlow, Neil

AU - Peacock, Janet L.

AU - Pillow, J. Jane

AU - Soll, Roger F.

AU - Thome, Ulrich H.

AU - Truffert, Patrick

AU - Schreiber, Michael D.

AU - Van Reempts, Patrick

AU - Vendettuoli, Valentina

AU - Vento, Giovanni

PY - 2010

Y1 - 2010

N2 - 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: Nestlé Belgium, Belgian Red Cross, and Dräger International.

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