High frequency oscillatory ventilation for adult patients with acute respiratory distress syndrome:an updated systematic review and meta-analysis

Objective To investigate whether high frequency oscillatory ventilation (HFOV) could reduce the 30 day mortality of adult patients with acute respiratory distress syndrome (ARDS) or increase ventilation associated risks compared with conventional mechanical ventilation (CMV).Methods Databases:VIP database,Wanfang Database,CBM,Pubmed,Embase,etc.were searched,including all related papers published up to May 2013.Revman 5.1 and Stata 12.0 were used to analyze data.Results Five randomized controlled trials with 1 677 participants with ARDS were included.There were no significant differences in 30 day mortality between HFOV and CMV (RR =0.92,95％ CI:0.67-1.27,P =0.62＞0.05).HFOV could not reduce the duration of ventilation compared with CMV (SMD=0.09,95％ CI:0.02-0.19,P =0.095＞0.05).The partial pressure of oxygen to inspired fraction of oxygen at day 1,day 2 and day 3 was higher in HFOV group than that in CMV group.And the use of HFOV would not lead to additional risks of ventilation.Conclusions HFOV might not improve survival of adult patients with ARDS compared with CMV,but it would not increase ventilation associated risks. Key words: Acute respiratory distress syndrome;  High frequency oscillatory ventilation;  Mortality; meta-analysis