High-Frequency Oscillation Ventilation Versus Conventional Mechanical Ventilation in Very Preterm Infants With Perinatal Acute Respiratory Distress Syndrome: Multicenters Randomized Controlled, Superiority Trial

NARecruitingINTERVENTIONAL
Enrollment

400

Participants

Timeline

Start Date

October 1, 2025

Primary Completion Date

June 30, 2028

Study Completion Date

December 31, 2028

Conditions
Acute Respiratory Distress SyndromeHigh Frequency Oscillatory VentilationPretermConventional Mechanical Ventilation
Interventions
DEVICE

HFOV

"HFOV + volume guarantee (VG) as the intervention group HFOV was provided only with piston or membrane oscillators capable of delivering true oscillatory pressure with an active expiratory phase (i.e., Acutronic FABIAN-III, SLE 5000, Löwenstein Med LEONI+, or Sensormedics 3100A). Other machines offering high frequency ventilation were excluded. The lung recruitment maneuver was performed as previously described, and lung volume was assessed by chest radiography or lung ultrasound, targeting the right diaphragm at the level of 8th-9th rib (or 7th-8th rib in case of air leak).~Crossover between HFOV and CMV This study allowed infants who failed to respond to their assigned ventilation mode to receive a trial of the alternate mode. Crossover criteria for HFOV-assigned neonates included failure for 3 hours to maintain SpO2 ≥ 50% despite FiO2 of 1.0, PaCO2 \> 60 mmHg for 3 hours, or signs of ventilator-induced cardiac output reduction. Non-responders to HFOV were switched to CMV."

DEVICE

CMV

"CMV as the standard group CMV was delivered by time-cycled, pressure-limited ventilators. Only pressure regulated volume control (PRVC) will be provided by any type of neonatal ventilator.~Crossover criteria for CMV-assigned neonates included failure for 3 hours to maintain SpO2 ≥ 50% despite FiO2 of 1.0, PaCO2 \> 60 mmHg for 3 hours, or requiring \> 30 cm H2O PIP to sustain ventilation. Non-responders to CMV were switched to HFOV.~Ventilator settings were adjusted at the discretion of the attending clinician to maintain a SpO2 between 90%-94%, a PaO2 between 50 and 80 mm Hg and a PaCO2 between 35 and 60 mm Hg and a pH between 7.20 and 7.45. PO2 and PCO2 levels were monitored using arterial blood gas analysis and/or transcutaneous monitoring in both groups."

Trial Locations (1)

400042

RECRUITING

Children's Hospital of Chongqing Medical University, Chongqing

Sponsors
All Listed Sponsors
collaborator

Children's Hospital of Chongqing Medical University

OTHER

collaborator

Jiulongpo No.1 People's Hospital

OTHER

collaborator

Chongqing Maternal and Child Health Hospital

OTHER

collaborator

The First Affiliated Hospital of Anhui Medical University

OTHER

collaborator

Children's Hospital of The Capital Institute of Pediatrics

OTHER

collaborator

Peking University Third Hospital

OTHER

collaborator

First Hospital of Tsinghua University

OTHER

collaborator

Women and Children's Hospital, Branch of Chongqing Sanxia Central Hospital

OTHER

collaborator

First Affiliated Hospital of Chongqing Medical University

OTHER

collaborator

Quanzhou Children's Hospital

OTHER

collaborator

Xiamen Maternity & Child Care Hospital

OTHER

collaborator

Zhujiang Hospital

OTHER

collaborator

Nanfang Hospital, Southern Medical University

OTHER

collaborator

Guangdong Academy of Medical Science and General Hospital

OTHER

collaborator

Guangdong Women and Children Hospital

OTHER

collaborator

Women and Children's Health Hospital of Yulin

OTHER

collaborator

Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region

OTHER

collaborator

Second Affiliated Hospital of Guangzhou Medical University

OTHER

collaborator

Guiyang Maternal and Child Health Care Hospital

OTHER

collaborator

The First People's Hospital of Zunyi

OTHER

collaborator

Lanzhou University Second Hospital

OTHER

collaborator

Gansu Provincial Maternal and Child Health Care Hospital

OTHER

collaborator

LanZhou University

OTHER

collaborator

First Affiliated Hospital of Harbin Medical University

OTHER

collaborator

First Affiliated Hospital of Xinjiang Medical University

OTHER

collaborator

Zhengzhou Children's Hospital, China

OTHER

collaborator

Third Affiliated Hospital of Zhengzhou University

OTHER

collaborator

the Maternal and Child Health Hospital of Hainan Province

OTHER

collaborator

Bethune International Peace Hospital

OTHER

collaborator

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

OTHER

collaborator

Children's Hospital of Nanjing Medical University

OTHER

collaborator

The First Hospital of Jilin University

OTHER

collaborator

Children's Hospital of Fudan University

OTHER

collaborator

Maternal and Children's Healthcare Hospital of Taian

OTHER

collaborator

The Second Hospital of Shandong University

OTHER

collaborator

Shanxi Provincial Maternity and Children's Hospital

OTHER

collaborator

Chengdu Women and Children's Center Hospital

OTHER

collaborator

The Affiliated Hospital Of Southwest Medical University

OTHER

collaborator

Affiliated Hospital of Southwest Medical University

OTHER

collaborator

Shenzhen People's Hospital, The Second Medical College of Jinan University

OTHER

collaborator

Tianjin Central Hospital of Gynecology Obstetrics

OTHER

collaborator

People's Hospital of Xinjiang Uygur Autonomous Region

OTHER

collaborator

Kunming Children's Hospital

OTHER

collaborator

The First People's Hospital of Yunnan

OTHER

collaborator

First Affiliated Hospital of Kunming Medical University

OTHER

collaborator

Yan'an Affiliated Hospital of Kunming Medical University

OTHER

collaborator

Women and Children's Health Hospital of Qujing

OTHER

collaborator

The People's Hospital of Dehong Autonomous Prefecture

OTHER

collaborator

The First People's Hospital of Yinchuan

OTHER

collaborator

The Children's Hospital of Zhejiang University School of Medicine

OTHER

collaborator

Women's Hospital School Of Medicine Zhejiang University

OTHER

collaborator

Beijing 302 Hospital

OTHER

collaborator

Hunan Children's Hospital

OTHER_GOV

collaborator

Women and Children Hospital of Qinghai Province

OTHER

collaborator

Jiangxi Province Children's Hospital

OTHER

collaborator

Inner Mongolia People's Hospital

OTHER

collaborator

Mianyang Central Hospital

OTHER

collaborator

People's Liberation Army No.202 Hospital

OTHER

collaborator

Ningbo Women & Children's Hospital

OTHER

collaborator

Shanghai Children's Medical Center

OTHER

collaborator

First Affiliated Hospital of Guangxi Medical University

OTHER

collaborator

Nanjing Medical University

OTHER

collaborator

Xianyang Children's Hospital

OTHER

collaborator

Qinhuangdao Maternal and Child Health Care Hospital

OTHER

collaborator

Xuzhou Children Hospital

OTHER

lead

Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

OTHER