A prospective, randomized, multicenter trial of high-frequency oscillatory ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome receiving surfactant☆,☆☆,★
Section snippets
Patients
Three level III centers participated in this trial. The study protocol was approved by the ethics committees of the hospitals involved, and written parental consent was obtained.
Patients were eligible for entry into the study if they weighed between 750 and 1500 gm at birth and exhibited respiratory distress syndrome. All enrolled infants received a natural bovine surfactant (Survanta 100 mg/kg, Abbott GmbH, Wiesbaden, Germany) when the chest x-ray film showed at least RDS II° and FiO2 > 0.6
Results
Between August 1993 and July 1995, 96 premature infants with a gestational age < 32 weeks entered our study. These patients qualified for the trial if chest x-ray films showed at least RDS II° and they needed more than FiO2 0.6 for sufficient oxygenation. The number of patients from the three centers ranged from 11 to 66; there were no center-specific biases in the patients' demographic characteristics, incidence of complications, or outcome. The study was paralleled by a sequential analysis
Discussion
While most previous reports highlighted the role of HFOV as a rescue method in premature infants and the prospective trials allowed an age at study entry from less than 6 hours to less than 48 hours, our trial initiated the randomized branch of ventilation within the first 2 hours of life, thus comparing HFOV and IPPV as primary ventilation modes.
Our ventilatory strategy was aimed at reducing pressures to avoid lung injury. We tried to apply an open lung strategy that we defined as accomplished
References (20)
- et al.
A multicenter randomized trial of high frequency oscillatory ventilation as compared with conventional mechanical ventilation in preterm infants with respiratory failure
Early Hum Dev
(1993) - et al.
Pulmonary interstitial emphysema treated by high-frequency oscillatory ventilation
Crit Care Med
(1986) - et al.
Extracorporeal membrane oxygenation and high-frequency oscillatory ventilation: potential therapeutic relationships
Crit Care Med
(1987) - et al.
High-frequency oscillatory ventilation and extracorporeal membrane oxygenation for the treatment of acute neonatal respiratory failure
Pediatrics
(1990) - et al.
High-frequency oscillatory ventilation and extracorporeal membrane oxygenation in severe persistent pulmonary hypertension of the newborn
Eur J Pediatr
(1992) High-frequency oscillatory ventilation compared with conventional mechanical ventilation in the treatment of respiratory failure in preterm infants
N Engl J Med
(1989)Treatment of respiratory failure in preterm infants
N Engl J Med
(1989)- et al.
Reflections on the HIFI Trial
Pediatrics
(1991) - et al.
Prospective randomized comparison of high-frequency oscillatory and conventional ventilation in respiratory distress syndrome
Pediatrics
(1992) Randomized study of high-frequency oscillatory ventilation in infants with severe respiratory distress syndrome
J Pediatr
(1993)
Cited by (0)
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From the Department of Pediatrics, Division of Neonatology, University Hospital Frankfurt a. Main, the Department of Pediatrics, University Hospital Cologne, and the Department of Pediatrics, University Hospital Mannheim, Federal Republic of Germany
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Reprint requests: Werner Rettwitz-Volk, MD, Zentrum der Kinderheilkunde, Abt. f. Neonatologie, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
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0022-3476/98/$5.00 + 0 9/21/82864