Early vs Conventional High-Frequency Oscillatory Ventilation in Moderate and Severe Acute Respiratory Distress syndrome: An Open Labelled Randomized Superiority Controlled Trial

Physiologically High Frequency Oscillatory Ventilation is better than Conventional Mechanical Ventilation as constant distending pressure with low tidal volume delivery reduces Ventilator-induced lung Injury. However, this didn’t translate into clinical practice as per studies done in adults. In the pediatric population, though HFOV is used as a rescue modality of ventilation, prospective studies to see the benefit of early HFOV versus conventional ventilation followed by rescue HFOV are lacking. Most of the evidence is from post hoc secondary analysis or retrospective analysis and patient selection too isn’t uniform across studies: Few of them have just considered post-marrow transplant recipients, and few of them have included patients with diagnoses other than severe ARDS. So, we propose to investigate the benefits of early HFOV over rescue HFOV usage in case of moderate and severe ARDS defined as per PALICC 1 guidelines by doing a randomized controlled trial in our setting.