High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: A randomized, controlled trial

Stephen Derdak, Sangeeta Mehta, Thomas E. Stewart, Terry Smith, Mark Rogers, Timothy G. Buchman, Brian Carlin, Stuart Lowson, John Granton

Research output: Contribution to journalArticlepeer-review

514 Scopus citations

Abstract

Observational studies of high-frequency oscillatory ventilation in adults with the acute respiratory distress syndrome have demonstrated improvements in oxygenation. We designed a multicenter, randomized, controlled trial comparing the safety and effectiveness of high-frequency oscillatory ventilation with conventional ventilation in adults with acute respiratory distress syndrome; 148 adults with acute respiratory distress syndrome (PaO2/fraction of inspired oxygen ≤ 200 mm Hg on 10 or more cm H2O positive end-expiratory pressure) were randomized to high-frequency oscillatory ventilation (n = 75) or conventional ventilation (n = 73). Applied mean airway pressure was significantly higher in the high-frequency oscillation group compared with the conventional ventilation group throughout the first 72 hours (p = 0.0001). The high-frequency oscillation group showed early (less than 16 hours) improvement in PaO2/fraction of inspired oxygen compared with the conventional ventilation group (p = 0.008); however, this difference did not persist beyond 24 hours. Oxygenation index decreased similarly over the first 72 hours in both groups. Thirty-day mortality was 37% in the high-frequency oscillation group and was 52% in the conventional ventilation group (p = 0.102). The percentage of patients alive without mechanical ventilation at Day 30 was 36% and 31% in the high-frequency oscillation and conventional ventilation groups, respectively (p = 0.686). There were no significant differences in hemodynamic variables, oxygenation failure, ventilation failure, barotraumas, or mucus plugging between treatment groups. We conclude that high-frequency oscillation is a safe and effective mode of ventilation for the treatment of acute respiratory distress syndrome in adults.

Original languageEnglish (US)
Pages (from-to)801-808
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume166
Issue number6
DOIs
StatePublished - Sep 15 2002
Externally publishedYes

Keywords

  • Acute respiratory distress syndrome
  • High-frequency oscillation
  • High-frequency ventilation
  • Mechanical ventilation
  • Oxygenation index

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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