Highlight
– A 2025 Cochrane systematic review including three randomized trials (368 infants) found very low- to low-certainty evidence that high-frequency oscillatory ventilation (HFOV) does not clearly reduce failed therapy or pulmonary air leaks compared with conventional ventilation (CV) in infants born ≥35 weeks with severe pulmonary dysfunction.
– Meta-analysis suggested a possible increase in mortality with HFOV (RR 1.47, 95% CI 0.92–2.34), but the evidence is low certainty and imprecise.
– No randomized data reported long-term neurodevelopmental outcomes; trials were small and predated many modern CV strategies, limiting applicability to current practice.
