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Thresholds for surfactant use in preterm neonates: a network meta-analysis

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F23%3A10452684" target="_blank" >RIV/00216208:11130/23:10452684 - isvavai.cz</a>

  • Result on the web

    <a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=hn.c.HFdaT" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=hn.c.HFdaT</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1136/archdischild-2022-324184" target="_blank" >10.1136/archdischild-2022-324184</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Thresholds for surfactant use in preterm neonates: a network meta-analysis

  • Original language description

    ObjectiveTo perform a network meta-analysis of randomised controlled trials of different surfactant treatment strategies for respiratory distress syndrome (RDS) to assess if a certain fraction of inspired oxygen (FiO(2)) is optimal for selective surfactant therapy. DesignSystematic review and network meta-analysis using Bayesian analysis of randomised trials of prophylactic versus selective surfactant for RDS. SettingCochrane Central Register of Controlled Trials, MEDLINE, Embase and Science Citation Index Expanded. PatientsRandomised trials including infants under 32 weeks of gestational age. InterventionsIntratracheal surfactant, irrespective of type or dose. Main outcome measuresOur primary outcome was neonatal mortality, compared between groups treated with selective surfactant therapy at different thresholds of FiO(2). Secondary outcomes included respiratory morbidity and major complications of prematurity. ResultsOf 4643 identified references, 14 studies involving 5298 participants were included. We found no statistically significant differences between 30%, 40% and 50% FiO(2) thresholds. A sensitivity analysis of infants treated in the era of high antenatal steroid use and nasal continuous positive airway pressure as initial mode of respiratory support showed no difference in mortality, RDS or intraventricular haemorrhage alone but suggested an increase in the combined outcome of major morbidities in the 60% threshold. ConclusionOur results do not show a clear benefit of surfactant treatment at any threshold of FiO(2). The 60% threshold was suggestive of increased morbidity. There was no advantage seen with prophylactic treatment. Randomised trials of different thresholds for surfactant delivery are urgently needed to guide clinicians and provide robust evidence. PROSPERO registration numberCRD42020166620.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30200 - Clinical medicine

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Archives of Disease in Childhood: Fetal and Neonatal Edition

  • ISSN

    1359-2998

  • e-ISSN

    1468-2052

  • Volume of the periodical

    108

  • Issue of the periodical within the volume

    4

  • Country of publishing house

    GB - UNITED KINGDOM

  • Number of pages

    9

  • Pages from-to

    333-341

  • UT code for WoS article

    000897876000001

  • EID of the result in the Scopus database

    2-s2.0-85144847450