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Table 2 Included randomized controlled trials - ventilation

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)

     
  1. Data presented as number/total (percentage) or mean ± standard deviation. AHRF, acute hypoxemic respiratory failure; BIPAP, biphasic positive airway pressure; CI, confidence interval; CLD, chronic lung disease; CV, conventional mechanical ventilation; HFO, high-frequency oscillation ventilation; iNO, inhaled nitric oxide; LOV, length of ventilation; ND, no data; NS, not significant; OR; odds ratio; VDR, volume diffusive respirator (high-frequency time-cycled pressure ventilator); PC, pressure-controlled ventilation; PS, pressure support ventilation.