High-frequency ventilation versus conventional ventilation for treatment of XXXX and @entity649 .

@entity1 @entity649 @entity26 @entity647
BACKGROUND: High-frequency ventilation is often used to treat @entity1 with @entity647 ( @entity647 ) or @entity649 ( @entity649 ) but the effect of this treatment on clinical outcomes has not been well established. OBJECTIVES: The objective of this review is to examine the effect of high-frequency ventilation compared with conventional ventilation as a therapy for @entity647 or @entity649 in @entity1 (1 to 17 years old) and adults in order to quantify its effect on @entity1 outcome (mortality, morbidity and other relevant outcomes). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, issue 4, 2002), MEDLINE (1966 to October Week 5, 2002), EMBASE (1980 to Week 51, 2002), World Wide Web (www.controlled-trials.com, @entity649 clinical network), and used Cited Reference Search (Web of Science 1988 to 2002, for specific reference lists of articles). We also contacted authors from each included trial, as well as manufacturers of high-frequency ventilators and other researchers in the field. SELECTION CRITERIA: Randomized controlled clinical trials of @entity1 and adults comparing treatment using high-frequency ventilation with conventional ventilation for @entity1 diagnosed with @entity647 or @entity649 . DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: Two trials met the inclusion criteria for this review. One trial recruited @entity1 (including some @entity1 less than one year old) (n = 58) and the other recruited adults (n = 148). Both trials used a high-frequency oscillatory ventilator as the intervention and included variable use of lung-volume recruitment strategies. The intervention groups showed a trend towards lower 30 day mortality ( @entity1 relative risk (RR) 0.83, 95% confidence interval (CI) 0.43 to 1.62; adults RR 0.72, 95% CI 0.50 to 1.03), although neither study showed a statistically significant difference. Similarly, there was no statistically significant difference between the intervention and control groups for 'Total length of ventilator days' (WMD) -2.00, 95% CI -18.36 to 14.36; and WMD 2.00, 95% CI -6.55 to 10.55 for the @entity1 and adult trials respectively). The studies used only proxies to measure long-term quality of life. There was a statistically significant reduction in the risk of requiring supplemental @entity26 amongst survivors at 30 days in the paediatric study (RR 0.36, 95% CI 0.14 to 0.93). REVIEWER'S CONCLUSIONS: There is not enough evidence to conclude whether high-frequency ventilation reduces mortality or long-term morbidity in @entity1 with @entity647 or @entity649 ; further trials are needed.
