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

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

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.