Efficacy and safety of surfactant administration via thin catheter in preterm infants with neonatal respiratory distress syndrome: A systematic review and meta‐analysis

Wu, Xiaohong; Feng, Zhoushan; Kong, Juan; Lai, Yiyu; Jia, Chunhong; Xu, Zhanyuan; Wu, Fan; Cui, Qiliang; Chen, Yaoyong

doi:10.1002/ppul.25545

Cited by 11 publications

(10 citation statements)

References 46 publications

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“…When selecting documents, the titles and abstracts would be first read to exclude irrelevant documents, and then the full text would be read to determine whether they could be included. The main content of data extraction was: (1) We also used the Newcastle-Ottawa Scale (NOS) to evaluate the methodological quality and risk of bias of included literature. The scale includes three columns including the selection of study subjects, comparability between groups, exposure or outcome evaluation, with a maximum score of nine points.…”

Section: Data Extraction and Outcomesmentioning

confidence: 99%

“…Neonatal respiratory distress syndrome (NRDS), formerly known as hyaline membrane disease (HMD), is a clinical syndrome characterized by respiratory distress and progressive aggravation soon after birth (1), mostly due to insufficient pulmonary surfactant secreted by alveolar type II epithelial cells, which is more common in premature infants in clinical practice (2). Neonates with younger gestational age tend to suffer from a higher incidence rate, lighter weight, and a higher fatality rate (3).…”

Section: Introductionmentioning

confidence: 99%

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Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Zang

Zhang

et al. 2022

Front. Pediatr.

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BackgroundIn recent years, vitamin D in the occurrence of lung diseases has gradually become a hot topic. Although the role of vitamin D in normal lung development has been confirmed, the correlation between vitamin D level and neonatal respiratory distress syndrome (NRDS) is not clear.ObjectiveTo evaluate the association between vitamin D level and NRDS.MethodsWe performed a comprehensive search of the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI). Literature screening and quality assessment were performed according to inclusion and exclusion criteria. The Newcastle–Ottawa Scale was used to assess the methodological components of each study, and Stata 15.1 software to perform the Meta-analysis.ResultsA total of nine case-control studies were included, with 653 infants with NRDS and 501 infants without NRDS. The Meta-analysis showed no heterogeneity across all studies(I2=0.0%, P=0.583). The fixed-effect model showed that 25 hydroxy vitamin D level of children in the NRDS group was significantly lower than that of the non-NRDS group(SMD = −0.51, 95%CI: −0.63 to −0.39, p ≤ 0.05).ConclusionThis systematic review and meta-analysis study suggests that vitamin D deficiency is very likely to be a high-risk factor of NRDS, and reasonable vitamin D supplementation during pregnancy and after birth is of great significance.

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Section: Data Extraction and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Zang

Zhang

et al. 2022

Front. Pediatr.

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“…Systematic literature reviews and meta-analyses comparing the LISA technique with mechanical ventilation, INSURE, or nasal CPAP alone have shown that LISA is associated with significantly improved outcomes for BPD or death and a reduced need for mechanical ventilation within 72 hours of birth [15,[18][19][20]36,37]. Failure of LISA was associated with younger gestational age (<28 weeks) and/or lack of prenatal steroids rather than the procedure itself or the surfactant used [29].…”

Section: Lisa: Past Clinical Evidence and Current Research Gapmentioning

confidence: 99%

“…Surfactant reflux is another outcome warranting more robust research since some groups have observed increased instances of reflux or bradycardia with LISA compared to INSURE when examining various types of surfactants [18,19,36]. Others have noted their expectation to observe higher rates of reflux with largervolume surfactants when utilizing LISA [24]; however, studies of the larger-volume surfactants such as bovine lipid extract surfactant (BLES) and Neosurf (5 mL/kg, 135 mg phospholipids per kg) administered with LISA have generated inconsistent data regarding reflux and reflux-related outcomes [45,56].…”

Section: Evidence Gaps and Future Directionsmentioning

confidence: 99%

Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant

Luna¹,

Unnebrink²,

Martinez-Tristani³

et al. 2022

Cureus

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Evidence supporting clinical recommendations or approval for less invasive surfactant administration (LISA) has primarily examined heterogeneous or small-volume (e.g., 1.25-2.5 mL/kg) animal-derived surfactant regimens. To address the evidence gap for larger-volume (e.g., 4-5 mL/kg) animal-derived surfactants, the aim of this review was to evaluate and summarize LISA literature for widely used larger-volume beractant. Surfactant treatment and the LISA technique were initially summarized. The available literature on beractant with LISA was thoroughly assessed and reviewed, including a recent systematic analysis, studies from regions where access or preferences may influence reliance on larger-volume surfactants, and investigations of short-and long-term outcomes. The available literature indicated improved short-term outcomes, including less need for mechanical ventilation, death, or bronchopulmonary dysplasia, and no negative long-term developmental outcomes when beractant was administered via LISA compared with older, more invasive techniques. The rates of short-term outcomes were similar to those previously observed in examinations of LISA with small-volume surfactants, including in populations reflecting very preterm infants. As uptake of LISA is expected to increase, future research directions for larger-volume surfactants include cost-effectiveness evaluations and robust examinations of repeat dosing and surfactant reflux to further inform clinical practice. This review provides a detailed assessment of the literature describing surfactant and LISA, with a focus on studies of beractant. Collectively, the available evidence supports the use of beractant with LISA based both on short-term and long-term outcomes relative to more invasive techniques and comparability of outcomes with small-volume surfactants and may be valuable in guiding clinical decision-making.

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“…Respiratory distress syndrome (RDS) is a clinical syndrome characterized by respiratory distress and progressive aggravation in affected neonates soon after birth and is one of the most common clinical conditions dealt with in the neonatal intensive care unit (NICU) (1). It is estimated to affect up to 7% of neonates and is among the major causes of neonatal mortality (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the neonatal sequential organ failure assessment and mortality risk in neonates with respiratory distress syndrome: A retrospective cohort study

Shi

Guo

et al. 2022

Front. Pediatr.

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BackgroundRespiratory distress syndrome (RDS) is one of the leading causes of neonatal death in the neonatal intensive care unit (NICU). Previous studies have suggested that the development of neonatal RDS may be associated with inflammation and lead to organ dysfunction. The neonatal sequential organ failure assessment (nSOFA) scoring system is an operational definition of organ dysfunction, but whether it can be used to predict mortality in neonates RDS is unknown. The aim of this study was to clarify the performance of the nSOFA score in predicting mortality in patients with neonatal RDS, with the aim of broadening the clinical application of the nSOFA score.MethodsNeonates with RDS were identified from the Medical Information Mart for Intensive Care (MIMIC)-III database. Cox proportional hazards model were used to assess the association between nSOFA score and mortality. Propensity score matched analysis were used to assess the robustness of the analytical results.ResultsIn this study of 1,281 patients with RDS of which 57.2% were male, death occurred in 40 cases (3.1%). Patients with high nSOFA scores had a higher mortality rate of 10.7% compared with low nSOFA scores at 0.3%. After adjusting for confounding, multivariate Cox proportional risk analysis showed that an increase in nSOFA score was significantly associated with increased mortality in patients with RDS [adjusted Hazards Ratio (aHR): 1.48, 95% Confidence Interval (CI): 1.32–1.67; p < 0.001]. Similarly, the High nSOFA group was significantly associated with higher mortality in RDS patients (aHR: 19.35, 95% CI: 4.41–84.95; p < 0.001) compared with the low nSOFA group.ConclusionThe nSOFA score was positively associated with the risk of mortality in cases of neonatal RDS in the NICU, where its use may help clinicians to quickly and accurately identify high risk neonates and implement more aggressive intervention.

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Efficacy and safety of surfactant administration via thin catheter in preterm infants with neonatal respiratory distress syndrome: A systematic review and meta‐analysis

Cited by 11 publications

References 46 publications

Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant

Evaluation of the neonatal sequential organ failure assessment and mortality risk in neonates with respiratory distress syndrome: A retrospective cohort study

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