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.
- CV, conventional ventilation
- HFOV, high frequency oscillatory ventilation
- UKOS, United Kingdom oscillation study
- high frequency ventilation
- respiratory function
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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.