What is the evidence for the use of HFOV in ARDS?

Intervention
Population
Conclusion

RCT: OSCAR

Young et al
NEJM (2013)

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  • Oscillatory Ventilation HFOV versus standard care
  • 795 patients with moderate or severe ARDS for <7 days
  • No difference in mortality at 28-days(41.7% vs. 41.1%, P=0.85)
The Bottom Line Review

RCT: OSCILLATE

Ferguson et al
NEJM (2013)

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  • HFOV versus standard care including lung protective ventilation
  • 548 patients with new-onset moderate or severe ARDS patients
  • Increased in-hospital mortality in ARDS patients treated with HFOV (47% vs. 35%, p=0.005)
The Bottom Line Review

Meta-analysis

Goligher et al
Annals ATS (2017)

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  • Ventilation strategies incorporating HFOV vs. conventional mechanical ventilation
  • 6 RCTs including a total of 1,715 patients with ARDS
  • Increased mortality with HFOV compared to lung-protective ventilation (RR 1.15, 95% CI 0.87-1.52)
  • Improved oxygenation with HFOV (mean P/F ratio 10mmHg higher)