TY - JOUR
TI - Systematic review found that using thin catheters to deliver surfactant to preterm neonates was associated with reduced bronchopulmonary dysplasia and mechanical ventilation
AU - Panza, R.
AU - Laforgia, N.
AU - Bellos, I.
AU - Pandita, A.
JO - Acta Paediatrica, International Journal of Paediatrics
PY - 2020
VL - 109
TODO - 11
SP - 2219-2225
PB - Wiley-Blackwell Publishing Ltd
SN - null
TODO - 10.1111/apa.15374
TODO - lung surfactant;  surfactant, artificial ventilation;  confidence interval;  female;  human;  intubation;  lung dysplasia;  male;  newborn;  observational study;  prematurity;  priority journal;  randomized controlled trial (topic);  respiratory distress syndrome;  Review;  risk factor;  systematic review;  artificial ventilation;  catheter;  infant;  lung dysplasia;  neonatal respiratory distress syndrome, Bronchopulmonary Dysplasia;  Catheters;  Humans;  Infant;  Infant, Newborn;  Pulmonary Surfactants;  Respiration, Artificial;  Respiratory Distress Syndrome, Newborn;  Surface-Active Agents
TODO - Aim: Surfactant delivery is a cornerstone for managing respiratory distress in preterm neonates, but data on the best surfactant delivery methods have been conflicting. Methods: A systematic literature review using the PubMed, Embase, Cochrane Library and Web of Science databases identified papers published up to November 5, 2019. Additional studies were identified from trial registries, conference proceedings and the reference lists of the selected papers. Results: We identified 15 studies covering 4926 preterm infants. The randomised controlled trials (RCTs) and observational studies both showed significant reductions in early intubation rates with use of thin catheters. The relative risk (RR) was 0.63 and the 95% confidence interval (95% CI) was 0.55-0.72 (P <.01), with an odds ratio (OR) of 0.40 and 95% CI of 0.35-0.45 (P <.0001). The collective results from the RCTs revealed a significant decrease in bronchopulmonary dysplasia (BPD) rates in the thin catheter group (RR, 0.47; 95% CI 0.33-0.66; P <.01). These findings were consistent with the observational studies (OR 0.47; 95% CI 0.43-0.52; P <.01). Conclusion: Using thin catheters to deliver surfactant in comparison with intubate-surfactant-extubate (INSURE) to newborn preterm infants with respiratory distress was associated with a reduced incidence of BPD and less need for mechanical ventilation. © 2020 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
ER -