HFOV Reduces the Risk for BPD in Preemies

A recent study in JAMA Open Network suggests that high-frequency oscillatory ventilation (HFOV) may reduce the incidence of bronchopulmonary dysplasia (BPD) compared with conventional ventilation in preterm infants with neonatal respiratory distress syndrome.

The randomized controlled trial was conducted among 386 infants in China born at or before 34 weeks’ gestation. All the infants were initially treated with conventional ventilation and then randomly assigned to remain on conventional ventilation or be switched to HFOV.

The investigators assessed the development of BPD using two widely used clinical definitions, the 2001 Eunice Kennedy Shriver National Institute of Child Health and Human Development definition and the 2019 Jensen definition. While BPD decreased under both definitions, the decrease was significantly greater under the newer Jensen definition: 32% vs. 8%.

Overall, 44.9% of infants in the conventional ventilation group developed BPD, compared with 34.3% in the HFOV group.

Other outcomes measured in the study, such as death, retinopathy of prematurity greater than stage 2, stage 2 or higher necrotizing enterocolitis, grade 3 or higher intraventricular hemorrhage, air leak, and hemodynamically significant patent ductus arteriosus, were similar between the HFOV and conventional ventilation groups.

The authors believe these findings demonstrate the value of HFOV in preterm infants with neonatal respiratory distress syndrome. “The results of this study suggest that elective HFOV is a promising strategy for preventing BPD in this high-risk population, especially the more severe forms linked to increased long-term morbidity and mortality,” they wrote. 

Highlighted in RC Buzz March 30, 2026