Systematic review found that using thin catheters to deliver surfactant to preterm neonates was associated with reduced bronchopulmonary dysplasia and mechanical ventilation
Raffaella Panza
Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, 'Aldo Moro’ University of Bari, Bari, Italy
Search for more papers by this authorNicola Laforgia
Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, 'Aldo Moro’ University of Bari, Bari, Italy
Search for more papers by this authorIoannis Bellos
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorCorresponding Author
Aakash Pandita
Department of Neonatology, SGPGIMS, Lucknow, UP, India
*Correspondence
Aakash Pandita, Consultant Neonatology, SGPGIMS, UP, India.
Email: [email protected]
Search for more papers by this authorRaffaella Panza
Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, 'Aldo Moro’ University of Bari, Bari, Italy
Search for more papers by this authorNicola Laforgia
Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, 'Aldo Moro’ University of Bari, Bari, Italy
Search for more papers by this authorIoannis Bellos
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorCorresponding Author
Aakash Pandita
Department of Neonatology, SGPGIMS, Lucknow, UP, India
*Correspondence
Aakash Pandita, Consultant Neonatology, SGPGIMS, UP, India.
Email: [email protected]
Search for more papers by this authorAbstract
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.
CONFLICT OF INTERESTS
The authors have no conflicts of interest to declare.
Supporting Information
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