ARDS: OSCILLATE

Question 1

Clinical Question OSCILLATE

Answer 1

In patients is moderate to severe early ARDS, does high-frequency oscillatory ventilation reduce in-hospital mortality?

Question 2

OSCILLATE Bottom Line

Answer 2

In patients with moderate to severe early ARDS, early high-frequency oscillatory ventilation might increase in-hospital mortality

Question 3

OSCILLATE Primary outcome

Answer 3

In-hospital mortality

Question 4

What is HFOV

Answer 4

high-frequency oscillatory ventilation

Question 5

OSCILLATE criticisms

Answer 5

• The authors identify that the trial was stopped early despite the stopping thresholds not being met and that the high mean airway pressure HFOV protocol may have led to worse outcomes than one with lower pressures
• The sedation strategy in the HFOV group may have led to higher mortality as patients may have been given higher doses of sedative and, subsequently, fluids

-The HFOV may have been initiated too late
Successful HFOV may take expertise not present at the study centers