Volume 18 Supplement 1

34th International Symposium on Intensive Care and Emergency Medicine

Open Access

Five-year single-centre review of ARDS patients receiving high-frequency oscillatory ventilation

  • N Pathmanathan1,
  • N Smith1,
  • V Allgar2,
  • R Rao1,
  • J Glazebrook1,
  • L Gray-Nicholson1 and
  • A Gratrix1
Critical Care201418(Suppl 1):P338

https://doi.org/10.1186/cc13528

Published: 17 March 2014

Introduction

Two recent RCTs (OSCAR and OSCILLATE [1],[2]) showed that high-frequency oscillatory ventilation (HFOV) had no positive impact on mortality. We present our experience over 5 years.

Methods

Adult ARDS patients who received HFOV from 2008 to 2012 were included. Demographics, illness severity and outcomes were collected retrospectively.

Results

A total of 118 patients were included; 56.8% were male, mean age was 54.8 years. RRT use was 45% during admission. Vasoactive agent use and neuromuscular blockade infusion rate was 81.9 and 29.7% pre HFOV respectively. The 28-day and 6-month mortality was 61.9 and 70.3%. A total of 60.1% had less than 48 hours conventional ventilation (CV) pre HFOV. The 6-month mortality was 64.8% for this group. Patients who had over 48 hours CV pre HFOV had a 6-month mortality of 76.6%. See Table 1.

Table 1

  

OSCAR

OSCILLATE

 

Hull

HFOV

Control

HFOV

Control

Mean APACHE II

22.0

21.8

21.7

29

29

Mean Vt (ml/kg predicted)

8.6

8.7

8.3

7.2

7.1

PaO2:FiO2 (mmHg)

81.5

113

113

121

114

Vasoactive agents (%)

81.9

43.5 (day 1)

44.6 (day 1)

67

63

Hospital mortality (%)

66.1

50.1

48.4

46.9

35.2

Conclusion

Mortality rates were higher than in recent trials [1],[2]. Our patients represent a more critically unwell group with lower PF ratios pre HFOV and high vasoactive and RRT use. HFOV may still have a role in the treatment of these very sick patients with treatment refractory to conventional ventilation.

Authors’ Affiliations

(1)
Hull and East Yorkshire Hospitals
(2)
Hull and York Medical School

References

  1. Young D, et al: High-frequency oscillation for ARDS. N Engl J Med. 2013, 368: 806-813. 10.1056/NEJMoa1215716.View ArticlePubMedGoogle Scholar
  2. Ferguson N, et al: High-frequency oscillation in early ARDS. N Engl J Med. 2013, 368: 795-805. 10.1056/NEJMoa1215554.View ArticlePubMedGoogle Scholar

Copyright

© Pathmanathan et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2014 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2014. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

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