The complications of premature infants receiving high－frequency ventilation vs conventional mechanical ventilation: a systematic review and meta－analysis / 中国新生儿科杂志

ABSTRACT

Objective To systematically evaluate the incidences of complications of high frequency oscillatory ventilation ( HFOV) and conventional mechanical ventilation ( CMV ) in premature infants. Method Randomized controlled trials of HFOV and CMV in premature infants published in databases including PubMed, Embase, Cochrane Library, CNKI Database, Wanfang Database, Weipu Chinese Sci－Tech Periodical Database were searched.The retrieval time was from the establishment of the databases to January 2018.The quality of the literature were evaluated , and Stata 15.0 statistical software was used for meta－analysis.Result A total of 18 articles and 3 888 premature infants were included in the study , including 1 910 in the HFOV group and 1 978 in the CMV group.No significant differences were found in the incidences of in－hospital mortality, air leakage syndromes , retinopathy of prematurity (ROP),≥grade 3 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and patent ductus arteriosus ( PDA) requiring medication or surgery ( P ＞0.05 ).The incidences of bronchopulmonary dysplasia (BPD) (RR ＝0.90,95%CI 0.83 ～0.98),≥grade 2 ROP (RR ＝0.78, 95%CI 0.63～0.96) and pulmonary hemorrhage (RR＝0.63, 95%CI 0.47～0.85) in HFOV group was significantly lower than the CMV group (P＜0.05).In the subgroup analysis, the results of the researches in 1980s, 1990s, 2000s, and 2010s showed that no significant differences existed in in－hospital mortality between the HFOV group and the CMV group on ventilator pressure control mode and volume control mode (P＞0.05).Conclusion Current evidences suggested that comparing with CMV , the application of HFOV in preterm infants might reduce the incidences of BPD ,≥grade 2 ROP and pulmonary hemorrhage.