High-frequency oscillatory ventilation in children: A systematic review and meta-analysis.
Pediatr Pulmonol
; 56(7): 1872-1888, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33902159
ABSTRACT
BACKGROUND:
High-frequency oscillatory ventilation (HFOV) is an alternative mechanical ventilation mode proposed to reduce ventilator-induced lung injuries and improve clinical outcomes. The aim of this study was to determine the effects of HFOV compared to conventional mechanical ventilation (CMV) when used in children with hypoxemic respiratory failure.METHODS:
The literature search was conducted to identify all studies published before December 2020. Eligible studies included a population aged between 28 days and 18 years old, presented original data from randomized controlled trials (RCTs) or observational studies, compared the use of HFOV with CMV. Meta-analyses of the pooled data were performed by using random-effects models with inverse-variance weighting.RESULTS:
A total of 11 studies (2605 cases) were included, most of them evaluating patients with acute respiratory distress syndrome. The mean age of participants was 8.2 months and the mean oxygenation index of those included in the RCTs was 24.4. The effect of HFOV on mortality was not significant, and clinically significant harm or benefit could not be excluded (risk ratio [RR], 0.93; 95% confidence interval [CI], 0.72 to 1.20). No significant difference between groups was found in duration of mechanical ventilation (-2.23; 95% CI, -5.07 to 0.61), treatment failure (RR, 0.28; 95% CI, 0.08 to 1.02), and occurrence of barotrauma (RR, 0.88; 95% CI, 0.39 to 1.99).CONCLUSION:
The scarce evidence currently available does not allow us to conclude that HFOV has advantages over CMV and further studies are needed to clarify its role in the treatment of acute hypoxemic respiratory failure in children.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Insuficiência Respiratória
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Ventilação de Alta Frequência
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Systematic_reviews
Limite:
Adult
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Child
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Child, preschool
/
Humans
Idioma:
En
Revista:
Pediatr Pulmonol
Assunto da revista:
PEDIATRIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Brasil