{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:18:14Z","timestamp":1774567094485,"version":"3.50.1"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,11,1]]},"abstract":"<jats:p>Objectives.\u2003To systematically review the evidence to determine whether the routine use of high-frequency oscillatory ventilation (HFOV) as compared with conventional ventilation (CV) is beneficial or harmful in preterm infants requiring mechanical ventilation for pulmonary failure principally due to respiratory distress syndrome.<\/jats:p><jats:p>Methods.\u2003All randomized controlled trials of elective HFOV versus CV in preterm infants &amp;lt;36 weeks' gestation with respiratory failure mainly attributable to respiratory distress syndrome were identified from the literature through a search of MEDLINE, EMBASE, Oxford database of Perinatal trials, and previous reviews including cross-references and abstracts. Meta-analyses using event rate ratios (ERR), event rate difference, and if significant, number needed-to-treat were calculated (95% confidence limits were used for all analyses). Two prespecified subgroup analyses were performed.<\/jats:p><jats:p>Results.\u2003Four published trials918 were included. Meta-analyses revealed the following ERR (95% confidence intervals) for HFOV versus CV: mortality at 28 to 30 days, 1.02 (0.76, 1.39); chronic lung disease (CLD) at 28 days, 0.86 (0.73, 1.01); mortality or CLD, 0.9 (0.80, 1.01); air-leak syndromes, 1.13 (0.97, 1.33); mechanical ventilation at 28 days, 1.06 (0.84, 1.33); supplemental oxygen at discharge, 0.59 (0.37, 0.92); intraventricular hemorrhage (IVH) all grades, 1.11 (0.95, 1.29); IVH (grades 3 or 4), 1.32 (1.01, 1.72); and periventricular leukomalacia, 1.39 (0.91, 2.13). In the subgroup of trials in which a high volume strategy (HVS) was used18 the ERR for CLD was 0.53 (0.36, 0.78); mortality or CLD, 0.56 (0.40, 0.77); supplemental oxygen at discharge, 0.57 (0.36, 0.92); IVH (all grades), 0.90 (0.61, 1.33); and IVH (grades 3 or 4), 0.84 (0.39, 1.84). Results were similar to these for the trials using surfactant.1920 One recent trial suggests that HFOV may reduce the cost of in-hospital care.19<\/jats:p><jats:p>Conclusions.\u2003The overall meta-analysis is dominated by the HIFI study,9 which was criticized for its methodology11 and surfactant was not used. Subsequent studies, most of which used HVS and\/or surfactant, have shown benefits in measures of CLD without an increase in rates of IVH. Caution is warranted in interpreting these results because: 1) the treatment is not blinded and this could affect some outcomes; 2) except for one small trial20 postneonatal survival, lung function, and neurodevelopment have not been reported from HVS trials; and 3) the benefits and disadvantages have not been reported in infants born at different gestational ages or different birth weights. Importantly, results from groups experienced in the use of HFOV may not be readily generalizable.<\/jats:p>","DOI":"10.1542\/peds.100.5.e6","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"e6-e6","source":"Crossref","is-referenced-by-count":29,"title":["Elective High-frequency Oscillatory Ventilation Versus Conventional Ventilation in Preterm Infants With Pulmonary Dysfunction: Systematic Review and Meta-analyses"],"prefix":"10.1542","volume":"100","author":[{"given":"Tushar","family":"Bhuta","sequence":"first","affiliation":[{"name":"1From the NSW Center for Perinatal Health Services Research at the University of Sydney and Department of Neonatal Medicine Royal Prince Alfred Hospital, Sydney, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Henderson-Smart","sequence":"additional","affiliation":[{"name":"1From the NSW Center for Perinatal Health Services Research at the University of Sydney and Department of Neonatal Medicine Royal Prince Alfred Hospital, Sydney, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1997,11,1]]},"reference":[{"key":"2021121006445016900_B1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0095-5108(18)30754-1","article-title":"Long term outcome of infants with respiratory disease.","volume":"14","author":"Saigal","year":"1987","journal-title":"Clin Perinatol."},{"key":"2021121006445016900_B2","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1542\/peds.76.5.725","article-title":"Long term morbidity of infants with bronchopulmonary dysplasia.","volume":"76","author":"Sauve","year":"1985","journal-title":"Pediatrics."},{"key":"2021121006445016900_B3","first-page":"694","article-title":"Bronchopulmonary dysplasia: unresolved neonate acute lung injury.","volume":"132","author":"O'Brodovich","year":"1985","journal-title":"Am Rev Respir Dis."},{"key":"2021121006445016900_B4","first-page":"528","article-title":"Bronchopulmonary dysplasia. 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