Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis (Preprint)

Abstract

BACKGROUND Feeding intolerance (FI) is usually a consequence of gastrointestinal immaturity (GI) and commonly occurs in premature infants, and it affects lots of premature infants, many studies have investigated pediatric Tui na for treating FI in premature infants, but to our knowledge, no systematic review, meta-analysis, or review protocol relevant to TCM-based pediatric Tui na for premature infants with FI has been published thus far. OBJECTIVE To develop a protocol for a systematic review and meta-analysis for evaluating the safety and efficacy of pediatric Tui na for premature infants with feeding intolerance (FI) METHODS We will conduct a thorough electronic literature search of Embase, Clarivate Analytics, PubMed, Cochrane Library, MEDLINE, Scopus, Springer, CINAHL, Physiotherapy Evidence Database (PEDro), World Health Organization International Clinical Trials Registry Platform, and Chinese biomedical databases (Wanfang database, the China National Knowledge Infrastructure database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database). Two reviewers will independently screen the studies based on titles and abstracts, and full-text reading of the eligible studies will be performed thereafter. Studies include any non-randomized controlled trials, non-randomized clinical studies, randomized controlled trials, and quasi-experimental studies wherein the treatment group involves premature infants with FI given pediatric Tui na. Primary outcomes will be necrotizing enterocolitis, gastric residual volume, emesis, blood in the stool, and abdominal distension. Secondary outcomes will be weight gain, time to achieve full enteral feeding, any adverse events associated with pediatric Tui na, and length of hospital stay. The Cochrane Collaboration Risk of Bias Tool will be used for risk of bias and methodological quality assessments. A meta-analysis of the efficacy will be performed if the studies included are sufficient, and publication bias evaluation using funnel plots will be performed, if possible. Subgroup analyses will be performed if the studies are sufficient and show substantial heterogeneity. RESULTS We will initiate review database searches in January 2023 and expect to have some findings by July 2023. CONCLUSIONS This protocol will help establish a framework of a high-quality literature synthesis on the impact of pediatric Tui na treatment for premature infants with FI. The efficacy and safety of pediatric Tui na for premature infants with FI will be determined by the proposed review. CLINICALTRIAL PROSPERO CRD 42023390021.

Pediatric Tui Na for Feeding Intolerance in Premature Infants: Protocol for a Systematic Review and Meta-Analysis

“…with PROSPERO (CRD42023390021) on February 8, 2023 [34]. We are currently in the study selection phase.…”

“…The protocol for this review has been registered with the National Institute for Health Research (PROSPERO 2023 CRD42023390021) [34]. This protocol will be reported and conducted according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Protocols) 2015 guidelines [35] and the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines [36].…”