title: Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data.
abstract: BACKGROUND
  Population and study design heterogeneity has confounded previous meta-analyses, leading to uncertainty about effectiveness and safety of elective high-frequency oscillatory ventilation (HFOV) in preterm infants. We assessed effectiveness of elective HFOV versus conventional ventilation in this group.
  
  
  METHODS
  We did a systematic review and meta-analysis of individual patients' data from 3229 participants in ten randomised controlled trials, with the primary outcomes of death or bronchopulmonary dysplasia at 36 weeks' postmenstrual age, death or severe adverse neurological event, or any of these outcomes.
  
  
  RESULTS
  For infants ventilated with HFOV, the relative risk of death or bronchopulmonary dysplasia at 36 weeks' postmenstrual age was 0.95 (95% CI 0.88-1.03), of death or severe adverse neurological event 1.00 (0.88-1.13), or any of these outcomes 0.98 (0.91-1.05). No subgroup of infants (eg, gestational age, birthweight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids) benefited more or less from HFOV. Ventilator type or ventilation strategy did not change the overall treatment effect.
  
  
  CONCLUSIONS
  HFOV seems equally effective to conventional ventilation in preterm infants. Our results do not support selection of preterm infants for HFOV on the basis of gestational age, birthweight for gestation, initial lung disease severity, or exposure to antenatal corticosteroids.
  
  
  BACKGROUND
  Nestlé Belgium, Belgian Red Cross, and Dräger International.
authors.affiliation: Neonatal Intensive Care Unit, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. filip.cools@uzbrussel.be
authors.forename: Filip
authors.initials: F
authors.lastname: Cools
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Askie
authors.forename: Martin
authors.initials: M
authors.lastname: Offringa
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Asselin
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Calvert
authors.forename: Sherry E
authors.initials: SE
authors.lastname: Courtney
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: David J
authors.initials: DJ
authors.lastname: Durand
authors.forename: Dale R
authors.initials: DR
authors.lastname: Gerstmann
authors.forename: David J
authors.initials: DJ
authors.lastname: Henderson-Smart
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.forename: Janet L
authors.initials: JL
authors.lastname: Peacock
authors.forename: J Jane
authors.initials: JJ
authors.lastname: Pillow
authors.forename: Roger F
authors.initials: RF
authors.lastname: Soll
authors.forename: Ulrich H
authors.initials: UH
authors.lastname: Thome
authors.forename: Patrick
authors.initials: P
authors.lastname: Truffert
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schreiber
authors.forename: Patrick
authors.initials: P
authors.lastname: Van Reempts
authors.forename: Valentina
authors.initials: V
authors.lastname: Vendettuoli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vento
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000209:etiology; D006612:High-Frequency Ventilation / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy*; D011175:Positive-Pressure Respiration / Q000009:adverse effects; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*