High-frequency oscillatory ventilation: the devil may be in the details.

The study by Sun et al1 in this issue of RESPIRATORY CARE, comparing high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation, merits close attention because it is one of few studies demonstrating clear benefit from HFOV, relative to conventional mechanical ventilation, in preterm infants. In the study, 336 preterm infants (gestational age 32 weeks, birth weight 1,500 g) who developed respiratory distress syndrome and required intubation and ventilator support within the first 24 hours of life were randomized to either HFOV (SLE5000 infant ventilator) or conventional synchronous