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A 26 week infant is about to be delivered by emergency caesarean section to a mother with placental abruption and fetal distress. No antenatal steroids have been administered to the mother. You are called to attend the delivery. You are setting up the equipment when the respiratory therapist suggests that we should use high frequency oscillatory ventilation (HFOV) as primary mode of ventilation. He also cites few articles suggesting benefit of high volume strategy HFOV over conventional ventilation (CV). You wonder if there is enough evidence to support the intervention.
Structured clinical question
In very low birth infants with respiratory distress syndrome [patient], is elective high frequency oscillatory ventilation using high volume strategy [intervention] better than conventional mechanical ventilation [comparison] in decreasing chronic lung disease or mortality at 36 weeks corrected gestational age [outcome]?
Search strategy and outcome
Secondary sources—Cochrane Library (Issue 4, 2002): (one relevant systematic review). Medline (1996–2002).
Cochrane: “high frequency ventilation” AND “infant, newborn” OR “infant, …
Footnotes
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Bob Phillips