A systematic review, meta-analysis and economic evaluation on Neonatal cpap

Keerthan, RM.; Nagaseshu, Pudi; Gopalan, G; Kachroo, Kavita; Sharma, Jitendar Kumar

doi:10.1515/cmb-2022-0133

Cited by 2 publications

(1 citation statement)

References 59 publications

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“…Mechanical ventilation can cause changes in lung air ow and blood gas levels, which can in turn affect blood ow in the brain, potentially leading to vessel rupture and bleeding [20,21]. Providing CPAP and PS assistance early during delivery has been proven to lessen the need for postnatal intubation [22][23][24]. Our research showed that infants who are unable to withdraw invasive ventilation within 1 week of birth are at a 3.668 times greater risk of developing PIVH than are those who on noninvasive ventilation.…”

Section: Risk Factors and Prediction For Pivh In The Elbwimentioning

confidence: 99%

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

Cai,

Jiang,

Wang

et al. 2024

Preprint

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Background This study aimed to explore the risk factors for early periventricular intraventricular hemorrhage (PIVH) in extremely low birth weight infants (ELBWIs), provide guidance for early intervention, and improve the survival rate and life expectancy of ELBWIs. Methods A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. The presence and severity of PIVH were assessed through standard head ultrasound screening (HUS) using the modified Papile classification on days 1–3 and 5–7 postbirth. The infants were categorized into either the PIVH group or the non-PIVH group based on the HUS findings. Univariate analysis and logistic regression were employed to identify the risk factors associated with PIVH. The efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve. Results Among the 205 ELBWIs (97 males and 108 females) included in the study, 82 patients (40.0%) developed PIVH, 26 patients (12.7%) had severe PIVH, and 56 patients (27.3%) had mild PIVH. Of the 82 PIVH cases, 51 occurred within 3 days after birth. The incidence rates of severe PIVH in the 23+ 1-26-, 26+ 1-28-, and 28+ 1-32-week gestational age groups were 40.0% (16/40), 10.7% (10/93), and 1.4% (1/72), respectively (χ2 = 34.392, p = 0.000). Logistic regression analysis revealed that failure to withdraw invasive ventilators within 1 week (OR = 3.668, 95% CI = 1.557–8.641, p = 0.003) and the use of vasoactive drugs within 1 week (OR = 2.193, 95% CI = 1.033–4.658, p = 0.041) were independent risk factors for PIVH (sensitivity = 68.3%).The specificity was 81.3%, and the AUC was 0.792. Conclusion The incidence of PIVH in extremely low birth weight infants is relatively high, particularly within the first three days after birth. The use of vasoactive drugs and delayed removal of invasive ventilators may increase the risk.

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Section: Risk Factors and Prediction For Pivh In The Elbwimentioning

confidence: 99%

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

Cai,

Jiang,

Wang

et al. 2024

Preprint

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Blinding Assessments in Neonatal Ventilation Meta-Analyses: A Systematic Meta-Epidemiological Review

Kuitunen,

Räsänen,

Gualano

et al. 2024

Neonatology

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Introduction: Randomization and blinding are generally important in randomized trials. In neonatology, blinding of ventilation strategies is unfeasible if not impossible and we hypothesized that its importance has been overestimated, while the peculiarities of the neonatal patient and the specific outcomes have not been considered. Methods: For this meta-epidemiological review, we searched PubMed and Scopus databases in November 2023. We included all meta-analyses focusing on ventilation, published in past 5 years, and reporting either mortality or bronchopulmonary dysplasia (BPD) as an outcome. We extracted the information about how the authors had analyzed risk of bias and evidence certainty. Results: We screened 494 abstracts and included 40 meta-analyses. Overall, 13 of the 40 reviews assessed blinding properly. Australian and European authors were most likely to perform correct assessment of the blinding (p = 0.03) and the use of RoB 2.0 tool was also associated with proper assessment (p < 0.001). In multivariate regression, the use of RoB 2.0 was the only factor associated with a proper assessment (Beta 0.57 [95% confidence interval: 0.29–0.99]). GRADE ratings were performed in 25 reviews, and the authors downgraded the evidence certainty due to risk of bias in 19 of these and none of these reviews performed the blinding assessment correctly. Conclusion: In past neonatal evidence syntheses, the role of blinding has been mostly overestimated, which has led to downgrading of evidence certainty. Objective outcomes (such as mortality and BPD) do not need to be downgraded due to lack of blinding, as the knowledge of the received intervention does not influence the outcome assessment.

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A systematic review, meta-analysis and economic evaluation on Neonatal cpap

Cited by 2 publications

References 59 publications

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

Blinding Assessments in Neonatal Ventilation Meta-Analyses: A Systematic Meta-Epidemiological Review

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