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Published Online First: 11 May 2006. doi:10.1136/adc.2005.079632
Archives of Disease in Childhood - Fetal and Neonatal Edition 2006;91:F320-F326
Copyright © 2006 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health
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ORIGINAL ARTICLE

Randomised trial of high frequency oscillatory ventilation or conventional ventilation in babies of gestational age 28 weeks or less: respiratory and neurological outcomes at 2 years

N Marlow1, A Greenough2, J L Peacock3, L Marston3, E S Limb4, A H Johnson5, S A Calvert5 for the United Kingdom Oscillation Study Group

1 School of Human Development, University of Nottingham, Nottingham, UK
2 Department of Child Health, Guy’s, King’s, St Thomas School of Medicine, King’s College London, UK
3 School of Health Sciences and Social Care, Brunel University, London, UK
4 Department of Community Health Sciences, St George’s Hospital Medical School, London, UK
5 Department of Child Health, St George’s Hospital Medical School, London, UK

Correspondence to:
Correspondence to:
Professor Marlow
Academic Division of Child Health, Queen’s Medical Centre, Nottingham NG7 2UH, UK; neil.marlow{at}nottingham.ac.uk

Background: The long term outcome of children entered into neonatal trials of high frequency oscillatory ventilation (HFOV) or conventional ventilation (CV) has been rarely studied.

Objective: To evaluate respiratory and neurodevelopmental outcomes for children entered into the United Kingdom Oscillation Study, which was designed to evaluate these outcomes.

Methods: Surviving infants were followed until 2 years of age corrected for prematurity. Study forms were completed by local paediatricians at routine assessments, and parents were asked to complete a validated neurodevelopmental questionnaire.

Results: Paediatricians’ forms were returned for 73% of the 585 surviving infants. Respiratory symptoms were common in all infants, and 41% had received inhaled medication. Mode of ventilation had no effect on frequency of any symptoms. At 24 months of age, severe neurodevelopmental disability was present in 9% and other disabilities in 38% of children, but the prevalence of disability was similar in children who received HFOV or CV (relative risk 0.93; 95% confidence interval 0.74 to 1.16). The prevalence of disability did not vary by gestational age, but boys were more likely to have overall disability. Developmental scores were unaffected by mode of ventilation (relative risk 1.13; 95% confidence interval 0.78 to 1.63) and were lower in infants born before 26 weeks gestation compared with babies born at 26–28 weeks.

Conclusions: Initial mode of ventilation in very preterm infants has no impact on respiratory or neurodevelopmental morbidity at 2 years. HFOV and CV appear equally effective for the early treatment of respiratory distress syndrome.

Abbreviations: CV, conventional ventilation; HFOV, high frequency oscillatory ventilation; UKOS, United Kingdom oscillation study

Keywords: premature; high frequency ventilation; development; respiratory function; disability


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