The primary outcome, 30-day all-cause mortality, occurred in 41.7% of the HFOV group (166 of 398 patients) and in 41.1% of the control group (163 of 397 patients), a nonsignificant difference. These rates remained largely unchanged in further analyses that adjusted for several variables, Dr. Young and his colleagues said (N. Engl. J. Med. 2013 Jan. 23 [doi:10.1056/NEJMoa1215716]).
The duration of ICU stay was 17.6 days with HFOV and 16.1 days with conventional ventilation, and the duration of hospital stay was 33.1 days and 33.9 days, respectively.
"Since data collection is ongoing, we cannot yet report the longer-term outcomes (including survival and health-related quality of life)," they added.
In conclusion, "we were unable to find any benefit or harm from the use of HFOV in adult patients with ARDS. We recommend that this mode of ventilation not be used for routine care," Dr. Young and his associates said.
The OSCILLATE study was supported by the Canadian Institutes of Health Research, the King Abdullah International Medical Research Center, and Fonds de Recherche de Quebec. Dr. Ferguson’s associates reported ties to numerous industry sources. The OSCAR study was supported by the National Institute for Health Research Health Technology Assessment Programme. Dr. Young and his associates reported no relevant financial conflicts of interest.
CareFusion provided the SensorMedics HFO ventilator and technical support for the OSCILLATE trial but had no role in study design, data collection or analysis, or manuscript preparation. Inspiration Healthcare supplied the ventilators for the OSCAR study but had no role in the study design, data acquisition or analysis, or manuscript preparation.