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Anesth Analg 2005;100:1765-1772
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000145070.52315.F2

CRITICAL CARE AND TRAUMA

High-Frequency Ventilation Versus Conventional Ventilation for the Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome: A Systematic Review and Cochrane Analysis

Hannah Wunsch, MD, MSc*, James Mapstone, MB Bchir, MSc, MA{dagger}, and Section Editor Jukka Takala

*Department of Anesthesiology, Columbia Presbyterian Medical Center, New York, New York; and {dagger}Castle Point & Rochford Primary Care Trust, Rayleigh, Essex, United Kingdom

Address correspondence and reprint requests to Hannah Wunsch, MD, MSc, Department of Anesthesiology, Columbia Presbyterian Medical Center, 630 W. 168th St., New York, NY 10032. Address e-mail to hannahwunsch{at}hotmail.com.

In this review, we examine outcomes from using high-frequency ventilation compared with conventional ventilation as therapy for acute lung injury and acute respiratory distress syndrome in children and adults. We conducted a systematic search of the literature based on the guidelines of the Cochrane Collaboration. Two trials met the inclusion criteria; one recruited children (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 toward less 30-day mortality (children: relative risk [RR], 0.83; 95% confidence interval [CI], 0.43–1.62; adults: RR, 0.72; 95% CI, 0.50–1.03), 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." There was a statistically significant reduction in the risk of requiring supplemental oxygen among survivors at 30 days in the pediatric study (RR, 0.36; 95% CI, 0.14–0.93). Overall there is not enough evidence to conclude that high-frequency ventilation reduces mortality or long-term morbidity in patients with acute lung injury or acute respiratory distress syndrome. (This review is published as a Cochrane Review in The Cochrane Library 2004, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the Review.)






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.