Wong JJM, Liu S, Dang H, et al. - Whether high-frequency oscillatory ventilation (HFOV) use vs other modes of mechanical ventilation is related to increased mortality in paediatric acute respiratory distress syndrome (PARDS), was investigated in this study with 328 patients with PARDS who were recruited from 10 paediatric intensive care units across Asia. HFOV was used to support 122/328 (37.2%) patients in the first 7 days of PARDS. Between the HFOV and non-HFOV groups, the baseline oxygenation index differed significantly. In PARDS, increased 28-day mortality was reported in relation to the use of HFOV. Exercising caution was suggested but this study does not eliminate equivocality.