Comparative efficacy and safety of pulmonary surfactant delivery strategies in neonatal RDS: a network meta-analysis
2024

Comparative Efficacy and Safety of Pulmonary Surfactant Delivery Strategies in Neonatal RDS

Sample size: 4035 publication 10 minutes Evidence: low

Author Information

Author(s): Liu Shiyue, Wang Yu, Zhu Xingwang, Chen Feifan, Shi Yuan

Primary Institution: Children’s Hospital of Chongqing Medical University

Hypothesis

To compare five pulmonary surfactant administration strategies for neonates with respiratory distress syndrome.

Conclusion

The thin catheter strategy minimized intubation risk and showed a better composite effect in reducing both mortality and BPD incidence.

Supporting Evidence

  • LMA and LISA significantly reduced intubation rates compared to usual care.
  • SN had a higher intubation rate compared to LISA and LMA.
  • LMA had a higher incidence of BPD compared to LISA.
  • SN ranked second to LISA in preventing BPD and death.
  • Most results were rated as low or very low quality.

Takeaway

This study looked at different ways to give medicine to help babies breathe better when they are born too early. Some methods worked better than others.

Methodology

A systematic search of MEDLINE, EMBASE, PUBMED, and Cochrane CENTRAL databases was conducted, followed by frequency-based random-effects network meta-analyses.

Potential Biases

Some studies were funded by pharmaceutical companies, which poses a high risk of bias.

Limitations

The study lacked clinical data on low gestational age and had significant variability in the volume of evidence across comparisons.

Participant Demographics

Infants aged 25–36 weeks, with 21.9% from Europe, 22.3% from North America, and 53.2% from Asia.

Statistical Information

P-Value

0.20 for LMA vs usual care, 0.17 for LISA vs usual care

Confidence Interval

95% CI: 0.09 to 0.42 for LMA, 95% CI: 0.09 to 0.32 for LISA

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/s12890-024-03429-4

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