Early randomized intervention with high-frequency jet ventilation in respiratory distress syndrome.

Academic Article

Abstract

  • To determine whether early use of high-frequency jet ventilation reduces neonatal mortality or pulmonary morbidity rates, we randomly selected 42 infants with clinical and radiographic evidence of severe respiratory distress syndrome to receive either high-frequency jet ventilation or conventional ventilation. Separate sequential analyses (two-sided, alpha = 0.05, power = 0.95 to detect 85:15 advantage) were performed for mortality rates, air leaks, bronchopulmonary dysplasia, intraventricular hemorrhage, and assignment crossover, and a combined analysis was performed, with death overriding other outcome variables. Enrollment was completed when the combined analysis reached the sequential design boundary indicating no treatment difference. Mortality rates (19% among infants receiving high-frequency jet ventilation vs 24% among infants receiving conventional ventilation), the incidence of air leaks (48% vs 52%), bronchopulmonary dysplasia (39% vs 41%), and intraventricular hemorrhage (33% vs 43%), and assignment crossovers (14% vs 24%) did not differs significantly between the treatment groups. We conclude that early use of high-frequency jet ventilation does not prevent or substantially reduce mortality or morbidity rates associated with assisted ventilation.
  • Authors

    Published In

    Keywords

  • Age Factors, Carbon Dioxide, Female, High-Frequency Jet Ventilation, Humans, Infant, Newborn, Male, Oxygen, Respiration, Artificial, Respiratory Distress Syndrome, Newborn, Time Factors
  • Author List

  • Carlo WA; Siner B; Chatburn RL; Robertson S; Martin RJ
  • Start Page

  • 765
  • End Page

  • 770
  • Volume

  • 117
  • Issue

  • 5