About: The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome

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About: The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome
Creator	Qian, Suyun Liu, Siqi Chor, Yek Lee, Jan Phan, Phuc Wong, Ming Anantasit, Nattachai Dang, Hongxing Feng, Mengling Gan, Chin Ju, Judith Loh, Tsee Ong, May Phumeetham, Suwannee Samransamruajkit, Rujipat Soo, Jacqueline
Source	PMC
abstract	BACKGROUND: High-frequency oscillatory ventilation (HFOV) use was associated with greater mortality in adult acute respiratory distress syndrome (ARDS). Nevertheless, HFOV is still frequently used as rescue therapy in paediatric acute respiratory distress syndrome (PARDS). In view of the limited evidence for HFOV in PARDS and evidence demonstrating harm in adult patients with ARDS, we hypothesized that HFOV use compared to other modes of mechanical ventilation is associated with increased mortality in PARDS. METHODS: Patients with PARDS from 10 paediatric intensive care units across Asia from 2009 to 2015 were identified. Data on epidemiology and clinical outcomes were collected. Patients on HFOV were compared to patients on other modes of ventilation. The primary outcome was 28-day mortality and secondary outcomes were 28-day ventilator- (VFD) and intensive care unit- (IFD) free days. Genetic matching (GM) method was used to analyse the association between HFOV treatment with the primary outcome. Additionally, we performed a sensitivity analysis, including propensity score (PS) matching, inverse probability of treatment weighting (IPTW) and marginal structural modelling (MSM) to estimate the treatment effect. RESULTS: A total of 328 patients were included. In the first 7 days of PARDS, 122/328 (37.2%) patients were supported with HFOV. There were significant differences in baseline oxygenation index (OI) between the HFOV and non-HFOV groups (18.8 [12.0, 30.2] vs. 7.7 [5.1, 13.1] respectively; p < 0.001). A total of 118 pairs were matched in the GM method which found a significant association between HFOV with 28-day mortality in PARDS [odds ratio 2.3, 95% confidence interval (CI) 1.3, 4.4, p value 0.01]. VFD was indifferent between the HFOV and non-HFOV group [mean difference − 1.3 (95%CI − 3.4, 0.9); p = 0.29] but IFD was significantly lower in the HFOV group [− 2.5 (95%CI − 4.9, − 0.5); p = 0.03]. From the sensitivity analysis, PS matching, IPTW and MSM all showed consistent direction of HFOV treatment effect in PARDS. CONCLUSION: The use of HFOV was associated with increased 28-day mortality in PARDS. This study suggests caution but does not eliminate equivocality and a randomized controlled trial is justified to examine the true association. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-020-2741-x) contains supplementary material, which is available to authorized users.
has issue date	2020-01-31(xsd:dateTime)
bibo:doi	10.1186/s13054-020-2741-x
bibo:pmid	32005285
has license	cc-by
sha1sum (hex)	8650fbb19778fbe2c5f506b2934259d9bc37de63
schema:url	https://doi.org/10.1186/s13054-020-2741-x
resource representing a document's title	The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome
has PubMed Central identifier	PMC6995130
has PubMed identifier	32005285
schema:publication	Crit Care
resource representing a document's body	covid:8650fbb19778fbe2c5f506b2934259d9bc37de63#body_text
is schema:about of	named entity 'inverse probability' named entity 'weighting' named entity 'paediatric' named entity 'score' named entity 'ventilation' named entity 'High-frequency' named entity 'analyse' named entity 'evidence' named entity 'evidence' named entity 'greater' named entity '2015' named entity 'sensitivity analysis' named entity 'hypothesized' named entity 'structural' named entity 'Methods' named entity 'intensive care unit' named entity 'acute respiratory distress syndrome' named entity 'harm' named entity 'modes' named entity 'acute respiratory distress syndrome' named entity 'ARDS' named entity 'Asia' named entity 'VFD' named entity 'organ dysfunction' named entity 'paediatric' named entity 'paediatric' named entity 'HFOV' named entity 'VFD' named entity 'hypoxemia' named entity 'non-parametric' named entity 'HFOV' named entity 'CMV' named entity 'acute respiratory failure' named entity 'HFOV' named entity 'odds ratio' named entity 'HFOV' named entity 'permissive hypercapnia' named entity 'algorithm' named entity 'normal distribution' named entity 'HFOV' named entity 'high-frequency oscillatory ventilation' named entity 'HFOV' named entity 'Hazard ratio' named entity 'prior knowledge' named entity 'CMV' named entity 'mode of ventilation' named entity 'HFOV' named entity 'Sedation' named entity '95% CI' named entity '0.01' named entity 'risk of death' named entity 'retrospective study' named entity 'acute respiratory distress syndrome' named entity 'lungs' named entity 'HFOV' named entity 'HFOV' named entity 'HFOV' named entity 'normal distribution' named entity 'acute respiratory failure' named entity 'HFOV' named entity 'Acute Lung Injury' named entity 'PICU' named entity 'gas exchange' named entity 'post hoc analysis' named entity 'Propensity Score Matching' named entity 'acute respiratory distress syndrome'

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