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High-Frequency Oscillation for Acute Respiratory Distress Syndrome
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2013
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MusicPerformance StudiesRespiratory Distress Syndrome (Pulmonary Critical Care)Respiratory Distress Syndrome (Neonatal Medicine)Sarah E.†ElectrophysiologySocial SciencesHigh-frequency OscillationMusic PsychologyArtsAcute MedicineBrian H.Respiration (Physiology)Musicology
ARDS patients require mechanical ventilation to maintain oxygenation, but this therapy can cause secondary lung injury. The study aimed to determine whether high‑frequency oscillatory ventilation (HFOV) reduces secondary lung injury in adults with ARDS. In a multicenter randomized trial, adults with PaO₂/FiO₂ ≤200 mm Hg and expected ventilation ≥2 days were assigned to HFOV with a Novalung R100 ventilator or conventional ventilation, with 30‑day mortality as the primary outcome. HFOV did not significantly affect 30‑day mortality compared with conventional ventilation (41.7 % vs 41.1 %; adjusted odds ratio 1.03, 95 % CI 0.75–1.40). The trial was funded by the National Institute for Health Research Health Technology Assessment Programme and registered as ISRCTN10416500.
Patients with the acute respiratory distress syndrome (ARDS) require mechanical ventilation to maintain arterial oxygenation, but this treatment may produce secondary lung injury. High-frequency oscillatory ventilation (HFOV) may reduce this secondary damage.In a multicenter study, we randomly assigned adults requiring mechanical ventilation for ARDS to undergo either HFOV with a Novalung R100 ventilator (Metran) or usual ventilatory care. All the patients had a ratio of the partial pressure of arterial oxygen (PaO) to the fraction of inspired oxygen (FiO) of 200 mm Hg (26.7 kPa) or less and an expected duration of ventilation of at least 2 days. The primary outcome was all-cause mortality 30 days after randomization.There was no significant between-group difference in the primary outcome, which occurred in 166 of 398 patients (41.7%) in the HFOV group and 163 of 397 patients (41.1%) in the conventional-ventilation group (P=0.85 by the chi-square test). After adjustment for study center, sex, score on the Acute Physiology and Chronic Health Evaluation (APACHE) II, and the initial PaO:FiO ratio, the odds ratio for survival in the conventional-ventilation group was 1.03 (95% confidence interval, 0.75 to 1.40; P=0.87 by logistic regression).The use of HFOV had no significant effect on 30-day mortality in patients undergoing mechanical ventilation for ARDS. (Funded by the National Institute for Health Research Health Technology Assessment Programme; OSCAR Current Controlled Trials number, ISRCTN10416500.).