Objective To investigate whether high frequency oscillatory ventilation (HFOV) could reduce the 30 day mortality of adult patients with acute respiratory distress syndrome (ARDS) or increase ventilation associated risks compared with conventional mechanical ventilation (CMV).Methods Databases:VIP database,Wanfang Database,CBM,Pubmed,Embase,etc.were searched,including all related papers published up to May 2013.Revman 5.1 and Stata 12.0 were used to analyze data.Results Five randomized controlled trials with 1 677 participants with ARDS were included.There were no significant differences in 30 day mortality between HFOV and CMV (RR =0.92,95％ CI:0.67-1.27,P =0.62＞0.05).HFOV could not reduce the duration of ventilation compared with CMV (SMD=0.09,95％ CI:0.02-0.19,P =0.095＞0.05).The partial pressure of oxygen to inspired fraction of oxygen at day 1,day 2 and day 3 was higher in HFOV group than that in CMV group.And the use of HFOV would not lead to additional risks of ventilation.Conclusions HFOV might not improve survival of adult patients with ARDS compared with CMV,but it would not increase ventilation associated risks.%目的 探索高频振荡通气与传统机械通气相比是否能降低成人ARDS患者的30 d死亡率,是否会增加人工通气相关风险.方法 在国内外各大主要数据库检索了2013年5月以前的所有相关文献,使用Revman 5.1及Stata 12.0软件分析处理数据.结果 meta分析纳入了5个随机对照试验共l 677例ARDS患者.通过分析发现,在降低30 d死亡率上高频振荡通气与传统机械通气没有明显差别(RR =0.92,95％ CI:0.67～1.27,P=0.62＞0.05).高频振荡通气不能减少呼吸机平均的使用时间(SMD=0.09,95％ CI:-0.02～0.19,P=0.095＞0.05).第1、2、3天的氧合指数高频振荡通气组较传统机械通气组有明显升高.同时分析发现使用高频振荡通气不会额外增加通气的相关风险.结论 高频振荡通气与传统机械通气相比不会显著改善成人ARDS患者的生存率,但它也不会增加机械通气的相关风险.
展开▼
