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Randomised trial of high frequency oscillatory ventilation or conventional ventilation in babies of gestational age 28 weeks or less: respiratory and neurological outcomes at 2 years
  1. N Marlow1,
  2. A Greenough2,
  3. J L Peacock3,
  4. L Marston3,
  5. E S Limb4,
  6. A H Johnson5,
  7. S A Calvert5,
  8. for the United Kingdom Oscillation Study Group
  1. 1School of Human Development, University of Nottingham, Nottingham, UK
  2. 2Department of Child Health, Guy’s, King’s, St Thomas School of Medicine, King’s College London, UK
  3. 3School of Health Sciences and Social Care, Brunel University, London, UK
  4. 4Department of Community Health Sciences, St George’s Hospital Medical School, London, UK
  5. 5Department of Child Health, St George’s Hospital Medical School, London, UK
  1. Correspondence to:
    Professor Marlow
    Academic Division of Child Health, Queen’s Medical Centre, Nottingham NG7 2UH, UK; neil.marlow{at}nottingham.ac.uk

Abstract

Background: The long term outcome of children entered into neonatal trials of high frequency oscillatory ventilation (HFOV) or conventional ventilation (CV) has been rarely studied.

Objective: To evaluate respiratory and neurodevelopmental outcomes for children entered into the United Kingdom Oscillation Study, which was designed to evaluate these outcomes.

Methods: Surviving infants were followed until 2 years of age corrected for prematurity. Study forms were completed by local paediatricians at routine assessments, and parents were asked to complete a validated neurodevelopmental questionnaire.

Results: Paediatricians’ forms were returned for 73% of the 585 surviving infants. Respiratory symptoms were common in all infants, and 41% had received inhaled medication. Mode of ventilation had no effect on frequency of any symptoms. At 24 months of age, severe neurodevelopmental disability was present in 9% and other disabilities in 38% of children, but the prevalence of disability was similar in children who received HFOV or CV (relative risk 0.93; 95% confidence interval 0.74 to 1.16). The prevalence of disability did not vary by gestational age, but boys were more likely to have overall disability. Developmental scores were unaffected by mode of ventilation (relative risk 1.13; 95% confidence interval 0.78 to 1.63) and were lower in infants born before 26 weeks gestation compared with babies born at 26–28 weeks.

Conclusions: Initial mode of ventilation in very preterm infants has no impact on respiratory or neurodevelopmental morbidity at 2 years. HFOV and CV appear equally effective for the early treatment of respiratory distress syndrome.

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Footnotes

  • Published Online First 11 May 2006

  • Competing interests: none declared

  • Members of the UKOS Study Group are as follows: Sandra Calvert, St George’s Hospital, London; Neil Marlow, University of Nottingham; Anne Greenough, Kings College Hospital Medical School, London; Janet Peacock, St George’s Hospital Medical School, London (statistician); Alice Johnson, St George’s Hospital, London; Louise Marston, St George’s Hospital Medical School, London (statistician); Elizabeth Limb, St George’s Hospital Medical School, London (statistician); Samantha Hart, St George’s Hospital Medical School, London (administrator); Hazel Beveridge, St George’s Hospital Medical School, London (administrator); Lorraine Gardiner, St George’s Hospital Medical School, London (administrator).

    UKOS Steering Group: Forrester Cockburn (Chair), Royal Hospital for Sick Children, Glasgow; Henry Halliday, Royal Maternity Hospital, Belfast; Leslie Davidson, National Perinatal Epidemiology Unit, Oxford; Sheena Dart, N Ireland (parent); Melanie Gill, Sussex (parent).

    UKOS Data Monitoring Group: Peter Pharoah (Chair), Department of Public Health, University of Liverpool; Janet Stocks, Institute Child Health, London; Ruth Gilbert, Institute Child Health, London.

    Participating centres: Birmingham Heartlands Hospital; Chelsea & Westminster Hospital, London; Guy’s & St Thomas’ Hospital, London; John Radcliffe Hospital, Oxford; Kings College Hospital, London; King George V Hospital, Sydney; KK Women’s and Children’s Hospital, Singapore; Medway Maritime Hospital, Kent; New Cross Hospital, Wolverhampton; Northampton General Hospital; Northwick Park Hospital, London; Nottingham City Hospital; Queen Charlotte’s Hospital, London; Queen’s Medical Centre, Nottingham; Princess Anne Hospital, Southampton; Rosie Maternity Hospital, Cambridge; Rotunda Hospital, Dublin; St George’s Hospital, London; St Michael’s Hospital, Bristol; St Peter’s Hospital, Chertsey; Simpson Memorial Hospital, Edinburgh; Singleton Hospital, Swansea; Southmead Hospital, Bristol.

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