From: Invasive ventilation modes in children: a systematic review and meta-analysis
Reference | Study population | Intervention/mode | Outcome measures | Level of evidence | |||
---|---|---|---|---|---|---|---|
 |  |  | Mortality/survival | LOV (days) | Oxygenation | CLD |  |
Arnold and colleagues [12] | 58 children (age: HFO 2.5 ± 2.5 vs. CV 3.1 ± 3.3 years) with diffuse alveolar disease and/or airleak syndrome | Multicenter study (five centers) | Number of survivors at 30 days - CV: 17 of 29 (59%); HFO: 19 of 29 (66%) (NS) | Total - CV: 22 ± 17; HFO: 20 ± 27 | PaO2/PAO2 increase over time (72 hours) in HFO compared with CV (P < 0.001) | CV: n = 10 (59%); HFO: n = 4 (21%) (P = 0.039; OR = 5.4 95% CI = 1.2 to 23.2) (O2 at 30 days) | 1+ |
 |  | Comparison effectiveness of HFO (n = 29) with CV (n = 29) - crossover | Death (ranked) - CV: 40%, CV to HFO: 42%, HFO: 6%, HFO to CV: 82% (P ≤0.001) | Survivors (at 30 days) - CV: 29 ± 18; HFO: 27 ± 31. | PaO2/PAO2 - HFO: 0.13 (0 hours) up to 0.26 (72 hours); CV: 0.13 (0 hours) up to 0.22 (72 hours) |  |  |
 |  | Crossover: CV to HFO (n = 19), HFO to CV (n = 11) |  | Nonsurvivors (at 30 days) - CV: 11 ± 9; HFO: 8 ± 6 (NS) | After crossover - PaO2/PAO2 increase over time (72 hours) in CV to HFO group compared with HFO to CV group (P = 0.003) |  |  |
Dobyns and colleagues [14] | 99 children (age 0 to 23 years) with AHRF, oxygenation index >15 | Multicenter study (seven centers) | Trend of improved survival in HFO + iNO - CV: 22 of 38 (58%); CV + iNO: 20 of 35 (53%); HFO: 7 of 12 (58%); HFO + iNO: 10 of 14 (71%) (P = 0.994) | CV: 22 ± 4; CV + iNO: 21 ± 3; HFO: 52 ± 28; HFO + iNO: 17 ± 4 (P = 0.098) | PaO2/FiO2 (PF) ratio - after 4 hours: HFO + iNO 136 ± 21 vs. CV 96 ± 6 (P = 0.2); after 12 hours: HFO + iNO 184 ± 45 vs. CV 107 ± 8 and CV + iNO 115 ± 9, HFO 136 ± 32 (P = 0.023); after 24 hours: treatment both HFO + iNO and HFO resulted in greater improvement in PF ratio than CV or CV + iNO (P = 0.005); after 72 hours: HFO 259 ± 60 vs. CV 148 ± 15 and CV + iNO 150 ± 19; HFO + iNO 213 ± 29 (P = 0.027) |  | 1+ |
 |  | Comparisons between patients treated with HFO + iNO (n = 14), HFO alone (n = 12), CV + iNO (n = 35), and CV alone (n = 38) |  |  |  |  |  |
Jaarsma and colleagues [13] | 18 children (age 0 to 10 years) with respiratory failure for ventilation | Single-center study | ND | BIPAP: 9.8 ± 9.2; PS: 6.4 ± 5.8 (P = 0.27) | ND |  | 1- |
 |  | Compare BIPAP (n = 11) with PS (n = 7), determining which mode is effective, safe and easy |  |  |  |  |  |
Carman and colleagues [16] | 64 children (age 7.4 ± 0.7 years) with inhalation injury | Single-center study | VDR: 2/32 (6%); PC: 5/32 (16%) (NS) | VDR: 12 ± 2; PCV: 11 ± 2 (NS) | PF ratio - VDR: 563 ± 16; PC: 507 ± 13 (P < 0.05) |  | 1- |
 |  | Compare VDR (n = 32) with PC (n = 32) |  |  |  |  |  |