High-Frequency Oscillation for Acute Respiratory Distress Syndrome

Young, Duncan; Lamb, Sarah E; Shah, Sanjoy; Mackenzie, Iain; Tunnicliffe, William; Lall, Ranjit; Rowan, Kathy; Cuthbertson, Brian H.

doi:10.1097/01.sa.0000435572.01496.5c

Cited by 40 publications

(46 citation statements)

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“…Two large RCTs evaluating routine HFOV in moderatesevere ARDS have been recently published [384,385]. One trial was stopped early because the mortality was higher in patients randomized to HFOV [384].…”

Section: We Recommend Against Using High-frequency Oscillatory Ventilmentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

et al. 2017

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Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". Design:A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods:The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable.

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Section: We Recommend Against Using High-frequency Oscillatory Ventilmentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

et al. 2017

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“…A survival benefit, however, has not been demonstrated with HFOV. In one randomized clinical trial, Young et al 35 found no significant difference between conventional ventilation and HFOV. Ferguson et al 36 randomly assigned adults with new-onset, moderate to severe ARDS to HFOV or to a control strategy targeting lung recruitment with the use of low V T and high PEEP.…”

Section: Types Of Recruitment Maneuversmentioning

confidence: 98%

Recruitment Maneuvers and PEEP Titration

2015

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The injurious effects of alveolar overdistention are well accepted, and there is little debate regarding the importance of pressure and volume limitation during mechanical ventilation. The role of recruitment maneuvers is more controversial. Alveolar recruitment is desirable if it can be achieved, but the potential for recruitment is variable among patients with ARDS. A stepwise recruitment maneuver, similar to an incremental PEEP titration, is favored over sustained inflation recruitment maneuvers. Many approaches to PEEP titration have been proposed, and the best method to choose the most appropriate level for an individual patient is unclear. A PEEP level should be selected that balances alveolar recruitment against overdistention. The easiest approach to select PEEP might be according to the severity of the disease: 5-10 cm H 2 O PEEP in mild ARDS, 10 -15 cm H 2 O PEEP in moderate ARDS, and 15-20 cm H 2 O PEEP in severe ARDS. Recruitment maneuvers and PEEP should be used within the context of lung protection and not just as a means of improving oxygenation.

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“…The authors of both studies reported satisfactory performance of these instruments in the respective patient populations. However, asking patients to complete these measures around the time of recruitment (commonly taken as the baseline measurement) into randomised controlled trials conducted within emergency and critical care settings can be problematic; patients are commonly incapacitated and unable to provide a self-assessment of their health status at or around the time of randomisation [13], [14]. Problems also arise because the event of interest is often acute in nature rather than pre-planned; the unknown timing makes it difficult to collect baseline data from participants during the occurrence of the event and at the point of recruitment into the trial.…”

Section: Introductionmentioning

confidence: 99%

Methodological Issues Surrounding the Use of Baseline Health-Related Quality of Life Data to Inform Trial-Based Economic Evaluations of Interventions Within Emergency and Critical Care Settings: A Systematic Literature Review

et al. 2017

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warwick.ac.uk/lib-publicationsOriginal citation: Dritsaki, Melina, Achana, Felix A., Mason, James and Petrou, Stavros. (2017) Methodological issues surrounding the use of baseline health-related quality of life data to inform trial-based economic evaluations of interventions within emergency and critical care settings : a systematic literature review. PharmacoEconomics. Permanent WRAP URL:http://wrap.warwick.ac.uk/85039 Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-for profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Publisher's statement:"The final publication is available at Springer via http://dx.doi.org/10.1007/s40273-016-0485-x " A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. Results: A total of 4224 published reports were screened, 19 of which met the study inclusion criteria (mean trial size 1,670); 14 (74 %) from the UK, 4 (21%) from other European countries and 1 (5%) from India. Twelve studies (63%) were based in emergency departments and 7 (37%) in intensive care units. Only one study was able to elicit patient-reported health-related quality of life at baseline. To overcome the lack of baseline data when estimating QALYs, 8 (42%) studies assigned a fixed utility weight corresponding to either death, an unconscious health state or a country-specific norm to patients at baseline, 4 (21%) ignored baseline utilities, 3 (16%) applied values from another study, 1 (5%) generated utility values via retrospective recall and 1 (5%) elicited utilities from experts. A preliminary exploration of these methods shows that incremental QALY estimation is unlikely to be biased if balanced trial allocation is achieved and subsequent collection of health-related quality of life data occurs at the earliest possible opportunity following commencement of treatment followed by adequate number of follow-up assessments. Conclusion:Trial-based cost-utility analyses within emergency and critical illness settings have applied different methods for QALY estimation, employing disparate assumptions about the health-related quality of life of patients at baseline. Where baseline measurem...

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High-Frequency Oscillation for Acute Respiratory Distress Syndrome

Cited by 40 publications

References 0 publications

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Recruitment Maneuvers and PEEP Titration

Methodological Issues Surrounding the Use of Baseline Health-Related Quality of Life Data to Inform Trial-Based Economic Evaluations of Interventions Within Emergency and Critical Care Settings: A Systematic Literature Review

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