Meta-analysis Of High-frequency Oscillatory Ventilation And Conventional Mechanical Ventilation In The Prevention Of BPD For Premature Infants

Objective:To systematically assess the efficacy and safety of highfrequency oscillatory ventilation(HFOV)and conventional mechanical ventilation(CMV)for preventing bronchopulmonary dysplasia(BPD)in premature infants requiring mechanical ventilation.Methods : The literatures of randomized controlled trials(RCT)on comparison between HFOV and CMV in the premature infants were retrieved by computer from the database of Pubmed,EMBASE,the Cohrane Library,Ovid,CNKI,Wip,and Wanfang Data Knowledge service Platform.Meanwhile the included reference literatures were recalled.The retrieval time was from the database establishment to July 2018.The two valuators independently conducted the literature screening,extracting the data,and evaluated the literature quality according to the inclusion and exclusion criteria.Then the RevMan 5.3 software was adopted to conduct the meta analysis.Results:A total of 20 English articles were finally included,involvingaccumulative 4676 patients.The results showed that there were no statistically significant differences between the HFOV and CMV groups in the preterm mortality,periventricular leukomalacia,air leak,retinopathy of prematurity(ROP),patent ductus arteriosus(PDA)and necrotizing enterocolitis(NEC).However compared with CMV,HFOV could reduce the incidence rate of BPD(OR=0.85,95%CI:0.74~0.96,P=0.010),and increased the risk of the grade 3-4 intraventricular hemorrhage(OR=1.36,95%CI:1.13~1.64,P=0.001).Conclusions: In the comparison between giving HFOV and CMV in premature infants requiring mechanical ventilation,HFOV can reduce the incidence rate of BPD,meanwhile increases the risk of intraventricular hemorrhage.