High-frequency oscillatory ventilation for PARDS: awaiting PROSPect

Excerpt

Recently, Wong et al. reported increased 28-day mortality among 328 children with pediatric acute respiratory distress syndrome (PARDS) managed with high-frequency oscillatory ventilation (HFOV) [1]. This study is an excellent example of gaining a better understanding of pediatric critical care through multicenter collaboration. Nonetheless, there are some nuances one should consider before interpreting the study results. Inherent to the study design, confounding by indication (i.e., the sickest patients are those most likely to receive a specific intervention) occurred albeit that the authors used advanced statistical techniques to address this. Furthermore, HFOV was largely employed as rescue without consistent criteria for its use and clinical management was done without a consistent protocol. …