BACKGROUND:Although conventional ventilation (CV) has decreased mortality,chronic lung disease (CLD) develops in 30% to 60% of preterm infants with RDS.In animal models, the use of high frequency oscillatory ventilation(HFOV) results in more uniform lung inflation pattern and reduces the severity of lung pathology produced by assisted ventilation. AIM:To review evidence whether the routine use of HFOV as compared to CV is beneficial or harmful in preterm infants requiring mechanical ventilation for pulmonary failure (principally RDS). STUDY SELECTION: All randomised controlled trials of elective HFOV versus CV in preterm infants < 35 weeks with respiratory failure mainly due to RDS. METHODS: Systematic search in accordance with Cochrane reviews. Meta-analysis using event rate ratios (ERR) and 99% CL were used for the subgroup analysis of “high volume strategy”(HVS). RESULTS: The ERRs of the outcomes from 5 trials were as follows: Table CONCLUSIONS: The meta-analysis showed no evidence of benefit but evidence of increased risk of IVH, however in the subgroup of patients where “high volume strategy” was used it is beneficial in terms of CLD and there is no significant difference in other outcomes.

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