Universität zu Köln

Kesler, Hanan, Lohmeier, Klaus, Hoehn, Thomas, Kribs, Angela and Peinemann, Frank (2022). Thin-catheter Surfactant Application for Respiratory Distress Syndrome in Spontaneously Breathing Preterm Infants: A Meta-analysis of Randomized Clinical Trials. Curr. Pediatr. Rev., 18 (4). S. 286 - 301. SHARJAH: BENTHAM SCIENCE PUBL LTD. ISSN 1875-6336

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Abstract

Background: Surfactant application by a thin catheter represented by the term less invasive surfactant administration (LISA) for respiratory distress syndrome in spontaneously breathing preterm infants was developed as an alternative to endotracheal intubation. Methods: We conducted a meta-analysis to assess the effects of LISA when compared to the so-called intubation-surfactant-extubation (INSURE) and the standard endotracheal intubation and mechanical ventilation (MV). The primary outcome was the composite incidence of death or bronchopulmonary dysplasia at a postmenstrual age of 36 weeks. The secondary outcome was the composite incidence of seven other severe adverse events. On 06 October 2021, we searched randomized clinical trials (RCTs) in PubMed, the Cochrane Library, ClinicalTrials.gov , and the ICTRP Registry. Results: We included 18 RCTs. The pooled data on the primary outcome favored LISA when compared to either INSURE (risk ratio 0.67; 95% CI, 0.51 to 0.88) or MV (risk ratio 0.78; 95% CI, 0.61 to 0.99). The pooled data on the second outcome also favored LISA when compared to INSURE (risk ratio 0.75; 95% CI, 0.60 to 0.94) and MV (risk ratio 0.73; 95% CI, 0.55 to 0.96). Conclusion: The findings showed that surfactant application by non-intubation respiratory support and the use of a thin catheter may decrease the composite risk of death or bronchopulmonary dysplasia. The included data support the view that LISA should be considered the preferred treatment option in eligible infants.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kesler, Hanan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmeier, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoehn, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Peinemann, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-673773
DOI:	10.2174/1573396318666220404194857
Journal or Publication Title:	Curr. Pediatr. Rev.
Volume:	18
Number:	4
Page Range:	S. 286 - 301
Date:	2022
Publisher:	BENTHAM SCIENCE PUBL LTD
Place of Publication:	SHARJAH
ISSN:	1875-6336
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTRATRACHEAL CATHETER; THERAPY; VENTILATION; EFFICACY Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67377