Early vs late high-frequency oscillatory ventilation in paediatric acute respiratory distress syndrome - A tertiary care centre experience

Rationale: Outcome data regarding the use of high -frequency oscillatory ventilation for the treatment of paediatric acute respiratory distress syndrome from low- and middle -income countries is limited. Objectives: To compare the outcomes of children with paediatric acute respiratory distress syndrome managed with early initiation of high -frequency oscillatory ventilation with those initiated after 48 h of intubation (late). Methods: Retrospective single centre observational study. Measurements and main results: Among the 17 subjects with paediatric acute respiratory distress syndrome (PaO2/FiO(2) ratio <200, Oxygenation index >8) with significant hypoxia on highfrequency oscillatory ventilation, 11 patients (65%) fell into the early group and 6 (35%) to the late group. The early group had significantly lower lactates at 12 (p= 0.02), 24(p= 0.03) and 36 h(p= 0.04) of initiation as compared to the late group. The mortality was 65 % and 100 % in the early and late groups respectively (p = 0.1).Conclusions: Early high -frequency oscillatory ventilation was associated with significantly lower lactate levels at different time points of initiation. It was not associated with any survival benefit.