Evacuación del meconiointestinal para mejorar tolerancia alimentaria en prematuro de muy bajo peso (protocolo Emita)

N, Patricia Mena; P, Jorge León Del; P, Daniela Sandino; B, Pamela Ralmolfo; Sabatelli, Debora; M, Adolfo Llanos; L, Beatriz Milet

doi:10.4067/s0370-41062014000300006

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…Saenz de Pipaón Marcos et al [28] found significantly increased TFF in the intervention versus control group [26 (21) vs. 15 (8) days, p = 0.005], but the regression analysis showed that patent ductus arteriosus rather than enema and rectal stimulation was significantly associated with an increased TFF. Results from the other studies [Haiden et al [25]: 26 (8-83) vs. 27 (5-75) days, p = 0.91; Mena et al [26]: 19.3 (8.2) vs. 20 (10.3) days; Khadr et al [24]: 7.4 (4.6-30.9) vs. 9 (4.4-13.3) days, p = 0.78, and Shinde et al [27]: 11.9 (3.1) vs. 11.3 (3.6) days] did not show any difference in TFF in the intervention versus control groups [24,25,26,27]. …”

Section: Resultsmentioning

confidence: 79%

“…Khadr et al [24] reported more cases of NEC in the glycerine suppository versus the control group (14 vs. 4%). Mena et al [26] noted less number of cases of NEC in the glycerol enema versus the control group (6 vs. 15%), and Shinde et al [27] found no NEC cases out of 25 neonates in the glycerine suppository arm as opposed to 1 out of 25 (0 vs. 4%) in the control arm. The overall pooled estimate showed no significant increase in risk of NEC in the intervention versus control groups (RR 1.71, 95% CI 0.63, 4.65, p = 0.30; χ 2 = 9.39; I 2 = 47%; fig.…”

Section: Resultsmentioning

confidence: 99%

“…2). Four of the 6 studies had TFF as the primary outcome [24,26,27,29], and those by Haiden et al [25] and Saenz de Pipaón Marcos et al [28] had TFF as the secondary outcome. We used the method of Hozo et al [30] to derive the mean and standard deviation from the median and range reported in the original article.…”

Section: Resultsmentioning

confidence: 99%

“…Mena et al [26] reported a 3-centre trial carried out in South America. Neonates (birth weight 500-1,250 g) were randomised to enemas with glycerol (0.8 ml glycerol + 3 ml saline or 1 ml glycerol + 5 ml saline depending on birth weight being under or over 800 g, respectively) versus rectal stimulation starting within the first 4 days.…”

Section: Resultsmentioning

confidence: 99%

“…The observational study by Shim et al [5] (n = 83) was excluded from the final analysis. Thus, a total of 6 studies (n = 442) assessing different interventions (glycerine suppository/enema, saline enema, oral osmotic contrast agent) for meconium evacuation were eligible for inclusion in the analysis [24,25,26,27,28,29]. The characteristics of these studies are shown in table 1.…”

Section: Resultsmentioning

confidence: 99%

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Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis

2016

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Background: A delayed passage of meconium is considered as a risk factor for feed intolerance in preterm neonates. Objectives: The aim of this study was to review the effects of different therapeutic agents for meconium evacuation on feed tolerance in preterm neonates. Methods: A systematic review of randomised controlled trials (RCTs) of different therapeutic agents for meconium evacuation in preterm neonates (gestation <32 weeks and/or birth weight <1,500 g) using the Cochrane systematic review methodology was undertaken. Databases including Google Scholar were searched in January 2016. The primary outcome was the time to reach full feeds (TFF; ≥120 ml/kg feeds with stoppage of parenteral nutrition >24 h). Secondary outcomes included necrotising enterocolitis (NEC), weight at discharge and adverse effects. The results were summarised as per the GRADE guidelines. Results: Six RCTs (2 each of glycerine suppository and enema, 1 normal saline enema and 1 oral osmotic contrast agent; n = 442) with a low or unclear risk of bias were included. The pooled estimate (random effects model) showed no reduction in TFF [mean difference (MD) -0.03, 95% CI -2.47, 2.41, p = 0.98; level of evidence: low]. No differences in NEC [risk ratio (RR) 1.71, 95% CI 0.63, 4.65, p = 0.30; level of evidence: low] and weight at discharge (MD -0.08, 95% CI -0.30, 0.15, p = 0.50; level of evidence: low) were found. The trial assessing oral osmotic contrast agents reported a trend towards a higher incidence of NEC ≥ stage II. There were no other adverse effects. Conclusion: Limited low-quality evidence indicates that prophylactic glycerine suppository, small volume glycerine/normal saline enema or oral osmotic contrast agents to evacuate meconium did not reduce TFF in preterm neonates. Large, well-designed trials are essential to study this clinically significant issue.

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Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis

2016

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Darmentleerung sehr unreifer Frühgeborener

Genzel‐Boroviczény

2018

Monatsschr Kinderheilkd

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Eligibility Criteria and Representativeness of Randomized Clinical Trials That Include Infants Born Extremely Premature: A Systematic Review

Pavlek

Rivera

Smith³

et al. 2021

The Journal of Pediatrics

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Objective To assess the eligibility criteria and trial characteristics among contemporary (2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019) randomized clinical trials (RCTs) that included infants born extremely preterm (<28 weeks of gestation) and to evaluate whether eligibility criteria result in underrepresentation of high-risk subgroups (eg, infants born at <24 weeks of gestation).Study design PubMed and Scopus were searched January 1, 2010, to December 31, 2019, with no language restrictions. RCTs with mean or median gestational ages at birth of <28 weeks of gestation were included. The study followed the PRISMA guidelines; outcomes were registered prospectively. Data extraction was performed independently by multiple observers. Study quality was evaluated using a modified Jadad scale.Results Among RCTs (n = 201), 32 552 infants were included. Study participant characteristics, interventions, and outcomes were highly variable. A total of 1603 eligibility criteria were identified; rationales were provided for 18.8% (n = 301) of criteria. Fifty-five RCTs (27.4%) included infants <24 weeks of gestation; 454 (1.4%) infants were identified as <24 weeks of gestation.Conclusions The present study identifies sources of variability across RCTs that included infants born extremely preterm and reinforces the critical need for consistent and transparent policies governing eligibility criteria.

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Evacuación del meconiointestinal para mejorar tolerancia alimentaria en prematuro de muy bajo peso (protocolo Emita)

Cited by 8 publications

References 16 publications

Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis

Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis

Darmentleerung sehr unreifer Frühgeborener

Eligibility Criteria and Representativeness of Randomized Clinical Trials That Include Infants Born Extremely Premature: A Systematic Review

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