Rescue high frequency oscillatory ventilation versus conventional ventilation for pulmonary dysfunction in preterm infants

Insufficient evidence exists to support the use of high frequency oscillatory ventilation instead of conventional ventilation for preterm infants with severe lung disease who are given positive pressure ventilation. High frequency oscillatory ventilation (HFOV) is a newer way of providing artificial ventilation of the lungs. Theoretically, HFOV may produce less injury to the lungs, particularly when high pressures are used on conventional positive pressure ventilation. This review of the evidence from one randomised controlled trial suggests there might be less short-term lung injury from high frequency oscillatory ventilation. However, more babies in this group developed haemorrhage in and around the fluid spaces in the brain (cerebral ventricles) and this harm might outweigh any benefit. More information is needed to clarify the balance between benefits and harms of high frequency oscillatory ventilation instead of conventional positive pressure ventilation for preterm infants with severe lung disease.