Evidence-Based Medicine Study Suggestion on High Frequency Oscillatory Ventilation in Neonates

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Objective Most of diseases which cause neonatal respiratory failure could use high frequency oscillatory ventilation (HFOV) or conventional ventilation (CV) to treat, but till now, it is unclear which is better. In this article, from the view of evidence-based medicine (EBM), we evaluate the effectiveness of high frequency oscillatory ventilation on the treatment of neonatal respiratory failure. Method We collected relative articles from Medline, EMBASE, Cochrane data base during January 1, 1983 to December 31, 2009, and then conducted systematic evaluation between high frequency oscillatory ventilation or conventional ventilation among preterm, low birth weight(LBW) infants (HFOV sub-group 1 and CV sub-group 1), term and near term infants(HFOV sub-group 2 and CV sub-group 2). Results Among preterm and low birth weight infants, there was no significant difference of incident rate of mortality, intracranial hemorrhage (ICH), periventricular leukomalacia (PVL), pneumothorax between HFOV sub-group 1 and CV sub-group 1 (P>0.05) during 28~30 days after birth. In HFOV sub-group 1, the incident rates of chronic lung disease (CLD) and retinopathy were obviously lower (P<0.05). As for term and near term infants, there still was no significant difference of mortality, pneumothorax, chronic lung disease, intracranial hemorrhage and periventricular leukomalacia rate between HFOV sub-group 2 and CV sub-group 2. Conclusion The existing evidence-based medicine can not show that high frequency oscillatory ventilation is much better than conventional ventilation in newborn respiratory failure. Key words: high frequency oscillatory ventilation (HFOV); conventional ventilation(CV); neonatal respiratory failure; Meta analysis