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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >New modalities to deliver surfactant in premature infants: a systematic review and meta-analysis
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New modalities to deliver surfactant in premature infants: a systematic review and meta-analysis

机译：在早产儿中提供表面活性剂的新方法：系统评价和荟萃分析

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Context: Surfactant is the principle treatment of respiratory distress syndrome, but the ideal method of its administration remains controversial. The intubation, surfactant administration and extubation (InSurE) method is proven to work but is invasive. The objective of this systematic review is to evaluate the efficacy and safety of the modalities of surfactant administration.Methods: We searched MEDLINE, EMBASE and CENTRAL (inception to December 2015) for randomized trials comparing new modalities with InSurE method. The primary outcome was mortality and development of bronchopulmonary dysplasia (BPD).Results: We screened 1837 citations and identified five unique trials were included; all were of unclear risk of bias. Four trials (400 infants) compared endotracheal catheters with InSurE, and one trial (70 infants) compared laryngeal masks (LMA) with InSurE. There was no significant difference between using endotracheal catheters compared with InSurE regarding infant mortality (risk ratio 1.05, 95% CI 0.57-1.94, 4 trials, 400 patients, p 0.87, I-2 0%) or BPD (risk ratio 0.73, 95% CI 0.43-1.21, 4 trials, 400 patients, p 0.22, I-2 0%). Adverse events were under-reported.Conclusion: The use of endotracheal catheters may provide comparable results to the InSurE method. There is limited evidence on the comparative efficacy of LMA.
机译：背景：表面活性剂是呼吸窘迫综合征的主要治疗方法，但其理想的给药方法仍存在争议。插管，表面活性剂管理和拔管（InSurE）方法已被证明是有效的，但具有侵入性。该系统评价的目的是评估表面活性剂给药方式的有效性和安全性。方法：我们在MEDLINE，EMBASE和CENTRAL（从2015年12月开始）中搜索了与InSurE方法比较新方式的随机试验。主要结果是死亡率和支气管肺发育不良（BPD）的发生。结果：我们筛选了1837篇文献，确定了5项独特的试验;所有人都有偏见的风险。四个试验（400例婴儿）将气管导管与InSurE进行了比较，一项试验（70例婴儿）将喉罩（LMA）与InSurE进行了比较。对于婴儿死亡率（风险比1.05，95％CI 0.57-1.94，4个试验，400名患者，p 0.87，I-2 0％）或BPD（风险比0.73，95），与InSurE相比，使用气管内导管之间没有显着差异。 ％CI 0.43-1.21，4个试验，400名患者，p 0.22，I-2 0％）。不良事件的报道较少。结论：气管内导管的使用可提供与InSurE方法相当的结果。关于LMA比较疗效的证据有限。

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