- Randomized, controlled trial comparing “lung protective” strategies on conventional ventilation to “open lung” strategies on high frequency oscillatory ventilation. Study was unable to be blinded by nature of interventions being compared.1
- Inclusion Criteria: patients older than 16 years, mechanically ventilated, meeting ARDS criteria (PaO2/FiO2 <= 200mmHg, PEEP >= 10cmH2O, bilateral radiographic infiltrates)
- Exclusion Criteria: left atrial hypertension, wt <= 35kg, severe COPD or asthma, intractable shock, severe airleak, non-pulmonary terminal diagnosis, FiO2 >= 0.8 for >48hr, recent participation in investigational study.
- Data collected at baseline, 2hr, 24hr, 48hr, 72hr, 30days, and 60days after randomization.
- Primary Outcomes: survival without need for mechanical ventilation at 30days after study entry.
- Secondary Outcomes: New/worsening airleak, mucus plugging requiring ETT change, six month mortality, intractable hypotension, oxygen failure, ventilation failure.
- Result: no statistically significant difference in primary or secondary outcomes between CV and HFOV.
- Statistically significant predictors of survival at 30 days after study entry irrespective of assigned ventilator were identified as OI response at 16hr (p=0.001), >5days ventilation prior to study initiation (p=0.032), APACHE II (p=0.002), and baseline pH (p=0.049)