Rescue high frequency oscillation and predictors of adverse neurodevelopmental outcome in preterm infants

Background: High frequency oscillation (HFO) is now frequently used as rescue support, but it has been suggested that as many as one-third of survivors have abnormal neurodevelopmental findings at follow-up. Objective: To identify risk factors for adverse neurodevelopmental outcome at 1 and 2 years in very prematurely born patients, who, because of severe neonatal respiratory failure, had required transfer to high frequency oscillation (HFO). Methods: A case control study was performed. Controls were supported by conventional mechanical ventilation (CMV) only and matched to HFO infants for gestational age. At 1 and 2 years, neurodevelopmental status was assessed in both groups. Abnormal neurodevelopmental outcome was diagnosed if infants had impairment with or without disability or a Griffiths developmental quotient of at least two standard deviations below the mean. Patients: Fifty-six infants were studied, median gestation age of 28 weeks (range 23–31). Results: At 2 years of age, a greater proportion of the HFO infants compared to the controls had an abnormal outcome ( p