Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schmölzer, GM; Kumar, M; Aziz, K; Pichler, G; O'Reilly, M; Lista, G; Cheung, PY.
Sustained inflation versus positive pressure ventilation at birth: a systematic review and meta-analysis.
Arch Dis Child Fetal Neonatal Ed. 2015; 100(4):F361-F368
Doi: 10.1136/archdischild-2014-306836
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Schmölzer Georg
- Co-Autor*innen der Med Uni Graz
- Pichler Gerhard
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- Abstract:
- Sustained inflation (SI) has been advocated as an alternative to intermittent positive pressure ventilation (IPPV) during the resuscitation of neonates at birth, to facilitate the early development of an effective functional residual capacity, reduce atelectotrauma and improve oxygenation after the birth of preterm infants. The primary aim was to review the available literature on the use of SI compared with IPPV at birth in preterm infants for major neonatal outcomes, including bronchopulmonary dysplasia (BPD) and death. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials, until 6 October 2014. Randomised clinical trials comparing the effects of SI with IPPV at birth in preterm infants for neonatal outcomes. Descriptive and quantitative information was extracted; data were pooled using a random effects model. Heterogeneity was assessed using the Q statistic and I(2). Pooled analysis showed significant reduction in the need for mechanical ventilation within 72 h after birth (relative risk (RR) 0.87 (0.77 to 0.97), absolute risk reduction (ARR) -0.10 (-0.17 to -0.03), number needed to treat 10) in preterm infants treated with an initial SI compared with IPPV. However, significantly more infants treated with SI received treatment for patent ductus arteriosus (RR 1.27 (1.05 to 1.54), ARR 0.10 (0.03 to 0.16), number needed to harm 10). There were no differences in BPD, death at the latest follow-up and the combined outcome of death or BPD among survivors between the groups. Compared with IPPV, preterm infants initially treated with SI at birth required less mechanical ventilation with no improvement in the rate of BPD and/or death. The use of SI should be restricted to randomised trials until future studies demonstrate the efficacy and safety of this lung aeration manoeuvre. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
- Find related publications in this database (using NLM MeSH Indexing)
- Bronchopulmonary Dysplasia - etiology
- Humans -
- Infant, Newborn -
- Infant, Premature -
- Insufflation - adverse effects
- Insufflation - methods
- Intermittent Positive-Pressure Ventilation - adverse effects
- Intermittent Positive-Pressure Ventilation - methods
- Positive-Pressure Respiration - adverse effects
- Positive-Pressure Respiration - methods
- Randomized Controlled Trials as Topic -
- Respiratory Distress Syndrome, Newborn - mortality
- Respiratory Distress Syndrome, Newborn - therapy
- Survival Analysis -