Maria Grazia Calevo1, Nicola Veronese2, Francesco Cavallin3, Cavicchioli Paola4, Massimo Micaglio5, Daniele Trevisanuto6. 1. Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini, Genoa, Italy. 2. National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy. 3. Independent statistician, Solagna, Italy. 4. Pediatric Department, Ospedale dell'Angelo, Mestre, Venice, Italy. 5. Department of Anesthesia and Intensive Care, Careggi University Hospital, Florence, Italy. 6. Department of Woman's and Child's Health, University of Padova, Padova, Italy. daniele.trevisanuto@unipd.it.
Abstract
OBJECTIVE: To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE. STUDY DESIGN: A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed RESULTS: Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38-0.85) and short-term oxygen requirements (MD -8.00, 95%CI -11.09 to -4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.43, 95%CI 0.31-0.61), but increased short-term oxygen requirements (MD 3.10, 95%CI 0.51-5.69) compared to INSURE approach. CONCLUSIONS: In preterm infants with RDS, surfactant administration via SAD reduces the need for intubation/mechanical ventilation. Overall, available literature includes few, small, poor-quality studies. Surfactant administration via SAD should be limited to clinical trials.
OBJECTIVE: To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE. STUDY DESIGN: A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed RESULTS: Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38-0.85) and short-term oxygen requirements (MD -8.00, 95%CI -11.09 to -4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.43, 95%CI 0.31-0.61), but increased short-term oxygen requirements (MD 3.10, 95%CI 0.51-5.69) compared to INSURE approach. CONCLUSIONS: In preterm infants with RDS, surfactant administration via SAD reduces the need for intubation/mechanical ventilation. Overall, available literature includes few, small, poor-quality studies. Surfactant administration via SAD should be limited to clinical trials.
Authors: Henry A Zapata; Prem Fort; Kari D Roberts; Dinushan C Kaluarachchi; Scott O Guthrie Journal: Front Pediatr Date: 2022-03-16 Impact factor: 3.418