High-frequency oscillatory ventilation for the prevention of XXXX of prematurity.

@entity1 @entity1545 @entity1576 @entity1030 @entity204
BACKGROUND: There remains uncertainty concerning the safety and efficacy of high-frequency oscillatory ventilation as compared with those of conventional ventilation for the respiratory support of very preterm @entity1 . We conducted a multicenter trial to determine whether early intervention with high-frequency oscillatory ventilation reduced mortality and the incidence of @entity1030 among newborns with a gestational age of 28 weeks or less. METHODS: We randomly assigned preterm @entity1 with a gestational age of 23 to 28 weeks to either conventional ventilation or high-frequency oscillatory ventilation within one hour after birth. Randomization was stratified according to center and gestational age (23 to 25 weeks or 26 to 28 weeks). RESULTS: A total of 400 @entity1 were assigned to high-frequency oscillatory ventilation, and 397 were assigned to conventional ventilation. The composite primary outcome ( @entity204 or @entity1030 , diagnosed at 36 weeks of postmenstrual age) occurred in 66 percent of the @entity1 assigned to receive high-frequency oscillatory ventilation and 68 percent of those in the conventional-ventilation group (relative risk in the group assigned to high-frequency oscillatory ventilation, 0.98; 95 percent confidence interval, 0.89 to 1.08). Similar proportions of @entity1 died or had @entity1030 in each gestational-age group. In both treatment groups treatment failure occurred in 10 percent of @entity1 (relative risk in the group assigned to high-frequency oscillatory ventilation, 0.99; 95 percent confidence interval, 0.66 to 1.50). There were no significant differences between the groups in a range of other secondary outcome measures, including serious @entity1545 and air leak. CONCLUSIONS: The results obtained with high-frequency oscillatory ventilation and conventional ventilation do not differ significantly in the early treatment of @entity1576 in very preterm @entity1 . Assessment of long-term effects will require additional follow-up.
