Mechanical Ventilation. In: DynaMed.
See a summary of current evidence in the “Ventilator Settings (Evidence)” section>High Frequency Oscillatory Ventilation (HFOV).
A systematic review ( Cochrane Database Syst Rev 2013 Feb 28;(2):CD004085) of studies (N=419) with methodological limitations concluded that may reduce mortality and treatment failure. However it did not include results of two recent RCTs:
1. HFOV does not reduce mortality compared to conventional ventilation (N Engl J Med 2013 Feb 28;368(9):806) RCT (N=795 adults with ARDS). RESULTS: All-cause mortality rate 41.7% for HFOV group v. 41.1% for conventional ventilation group (not significant).
2. HFOV may increase risk of mortality compared to conventional ventilation protocol. RCT (N=548 adults with moderate to severe ARDS). RESULTS: 12% of patients in control group received HFOV for refractory hypoxemia. In-hospital mortality 47% for HFOV group vs. 35% for control group.
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