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

Identifikátory výsledku

  • Kód výsledku v 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>

  • Výsledek na webu

    <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>

Alternativní jazyky

  • Jazyk výsledku

    angličtina

  • Název v původním jazyce

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

  • Popis výsledku v původním jazyce

    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.

  • Název v anglickém jazyce

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

  • Popis výsledku anglicky

    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.

Klasifikace

  • Druh

    J<sub>imp</sub> - Článek v periodiku v databázi Web of Science

  • CEP obor

  • OECD FORD obor

    30200 - Clinical medicine

Návaznosti výsledku

  • Projekt

  • Návaznosti

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Ostatní

  • Rok uplatnění

    2023

  • Kód důvěrnosti údajů

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

Údaje specifické pro druh výsledku

  • Název periodika

    Archives of Disease in Childhood: Fetal and Neonatal Edition

  • ISSN

    1359-2998

  • e-ISSN

    1468-2052

  • Svazek periodika

    108

  • Číslo periodika v rámci svazku

    4

  • Stát vydavatele periodika

    GB - Spojené království Velké Británie a Severního Irska

  • Počet stran výsledku

    9

  • Strana od-do

    333-341

  • Kód UT WoS článku

    000897876000001

  • EID výsledku v databázi Scopus

    2-s2.0-85144847450