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Dublin Core
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April 2021 List
Text
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April 2021 List
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<a href="http://doi.org/10.1186/s12890-020-1144-8" target="_blank" rel="noreferrer noopener">http://doi.org/10.1186/s12890-020-1144-8</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Complications and mortality of venovenous extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure: a systematic review and meta-analysis
Publisher
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BMC Pulmonary Medicine
Date
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2020
Subject
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Humans; Infant Newborn; Survival Rate; Pneumothorax/etiology; Systematic reviews; Meta-analysis; Neonate; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation/adverse effects/mortality; Hypertension/etiology; Observational Studies as Topic; Respiratory Distress Syndrome Newborn/mortality/therapy; Respiratory failure
Creator
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Xiong J; Zhang L; Bao L
Description
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BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. To systematically evaluate the complications and mortality of venovenous ECMO (VV ECMO) in the treatment of neonatal respiratory failure, we performed a systematic review and meta-analysis of all the related studies. METHODS: PubMed, Embase, and Cochrane Library were searched. The retrieval period was from the establishment of the database to February 2019. Two investigators independently screened articles according to the inclusion and exclusion criteria. The quality of article was assessed by the Newcastle-Ottawa scale (NOS). The meta-analysis was performed by Stata 15.0 software. RESULTS: Four observational studies were included, with a total of 347 newborns. VV ECMO was used for neonates with refractory respiratory failure unresponsive to maximal medical therapy. Median ages of the newborns at cannulation were 43.2 h, 23 h, 19 h, and 71 h in the included four studies, respectively. The overall mortality at hospital charge was 12% (5-18%) with a heterogeneity of I(2) = 73.8% (p = 0.01). Two studies reported mortality during ECMO and after decannulation, with 10% (0.8-19.2%) and 6.1% (2.6-9.6%), respectively. The most common complications associated with VV ECMO were: pneumothorax (20.6%), hypertension (20.4%), cannula dysfunction (20.2%), seizure (14.9%), renal failure requiring hemofiltration (14.7%), infectious complications (10.3%), thrombi (7.4%), intracranial hemorrhage or infarction (6.6%), hemolysis (5.3%), cannula site bleeding (4.4%), gastrointestinal bleeding (3.7%), oxygenator failure (2.8%), other bleeding events (2.8%), brain death (1.9%), and myocardial stun (0.9%). CONCLUSION: The overall mortality at discharge of VV ECMO in the treatment of neonatal respiratory failure was 12%. Although complications are frequent, the survival rate during hospitalization is still high. Further larger samples, and higher quality of randomized controlled trials (RCTs) are needed to clarify the efficacy and safety of this technique in the treatment of neonatal respiratory failure.
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<a href="http://doi.org/10.1186/s12890-020-1144-8" target="_blank" rel="noreferrer noopener">10.1186/s12890-020-1144-8</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
April 2021 List
Bao L
BMC Pulmonary Medicine
Extracorporeal Membrane Oxygenation
Extracorporeal Membrane Oxygenation/adverse effects/mortality
Humans
Hypertension/etiology
Infant Newborn
Meta-Analysis
Neonate
Observational Studies as Topic
Pneumothorax/etiology
Respiratory Distress Syndrome Newborn/mortality/therapy
respiratory failure
Survival Rate
Systematic reviews
Xiong J
Zhang L
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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January 2021 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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January 2021 List
URL Address
<a href="http://doi.org/10.1002/14651858.CD002271.pub3" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/14651858.CD002271.pub3</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants
Publisher
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Cochrane Database of Systematic Reviews
Date
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2020
Subject
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Humans; Infant Newborn; Treatment Failure; Infant Premature; Randomized Controlled Trials as Topic; Selection Bias; Infant Low Birth Weight; Pneumothorax/etiology; Outcome Assessment Health Care; Bronchopulmonary Dysplasia/etiology; Continuous Positive Airway Pressure/adverse effects/methods; Intermittent Positive-Pressure Ventilation/adverse effects; Pulmonary Surfactants/therapeutic use; Respiratory Insufficiency/prevention & control; Respiratory Distress Syndrome Newborn/mortality/therapy
Creator
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Ho JJ; Subramaniam P; Davis PG
Description
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BACKGROUND: Respiratory distress, particularly respiratory distress syndrome (RDS), is the single most important cause of morbidity and mortality in preterm infants. In infants with progressive respiratory insufficiency, intermittent positive pressure ventilation (IPPV) with surfactant has been the usual treatment, but it is invasive, potentially resulting in airway and lung injury. Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of respiratory distress, as well as for the prevention of apnoea, and in weaning from IPPV. Its use in the treatment of RDS might reduce the need for IPPV and its sequelae. OBJECTIVES: To determine the effect of continuous distending pressure in the form of CPAP on the need for IPPV and associated morbidity in spontaneously breathing preterm infants with respiratory distress. SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search CENTRAL (2020, Issue 6); Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions; and CINAHL on 30 June 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: All randomised or quasi-randomised trials of preterm infants with respiratory distress were eligible. Interventions were CPAP by mask, nasal prong, nasopharyngeal tube or endotracheal tube, compared with spontaneous breathing with supplemental oxygen as necessary. DATA COLLECTION AND ANALYSIS: We used standard methods of Cochrane and its Neonatal Review Group, including independent assessment of risk of bias and extraction of data by two review authors. We used the GRADE approach to assess the certainty of evidence. Subgroup analyses were planned on the basis of birth weight (greater than or less than 1000 g or 1500 g), gestational age (groups divided at about 28 weeks and 32 weeks), timing of application (early versus late in the course of respiratory distress), pressure applied (high versus low) and trial setting (tertiary compared with non-tertiary hospitals; high income compared with low income) MAIN RESULTS: We included five studies involving 322 infants; two studies used face mask CPAP, two studies used nasal CPAP and one study used endotracheal CPAP and continuing negative pressure for a small number of less ill babies. For this update, we included one new trial. CPAP was associated with lower risk of treatment failure (death or use of assisted ventilation) (typical risk ratio (RR) 0.64, 95% confidence interval (CI) 0.50 to 0.82; typical risk difference (RD) -0.19, 95% CI -0.28 to -0.09; number needed to treat for an additional beneficial outcome (NNTB) 6, 95% CI 4 to 11; I(2) = 50%; 5 studies, 322 infants; very low-certainty evidence), lower use of ventilatory assistance (typical RR 0.72, 95% CI 0.54 to 0.96; typical RD -0.13, 95% CI -0.25 to -0.02; NNTB 8, 95% CI 4 to 50; I(2) = 55%; very low-certainty evidence) and lower overall mortality (typical RR 0.53, 95% CI 0.34 to 0.83; typical RD -0.11, 95% CI -0.18 to -0.04; NNTB 9, 95% CI 2 to 13; I(2) = 0%; 5 studies, 322 infants; moderate-certainty evidence). CPAP was associated with increased risk of pneumothorax (typical RR 2.48, 95% CI 1.16 to 5.30; typical RD 0.09, 95% CI 0.02 to 0.16; number needed to treat for an additional harmful outcome (NNTH) 11, 95% CI 7 to 50; I(2) = 0%; 4 studies, 274 infants; low-certainty evidence). There was no evidence of a difference in bronchopulmonary dysplasia, defined as oxygen dependency at 28 days (RR 1.04, 95% CI 0.35 to 3.13; I(2) = 0%; 2 studies, 209 infants; very low-certainty evidence). The trials did not report use of surfactant, intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis and neurodevelopment outcomes in childhood. AUTHORS' CONCLUSIONS: In preterm infants with respiratory distress, the application of CPAP is associated with reduced respiratory failure, use of mechanical ventilation and mortality and an increased rate of pneumothorax compared to spontaneous breathing with supplemental oxygen as necessary. Three out of five of these trials were conducted in the 1970s. Therefore, the applicability of these results to current practice is unclear. Further studies in resource-poor settings should be considered and research to determine the most appropriate pressure level needs to be considered.
Identifier
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<a href="http://doi.org/10.1002/14651858.CD002271.pub3" target="_blank" rel="noreferrer noopener">10.1002/14651858.CD002271.pub3</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Bronchopulmonary Dysplasia/etiology
Cochrane Database of Systematic Reviews
Continuous Positive Airway Pressure/adverse effects/methods
Davis PG
Ho JJ
Humans
Infant Low Birth Weight
Infant Newborn
Infant Premature
Intermittent Positive-Pressure Ventilation/adverse effects
January 2021 List
Outcome Assessment Health Care
Pneumothorax/etiology
Pulmonary Surfactants/therapeutic use
Randomized Controlled Trials as Topic
Respiratory Distress Syndrome Newborn/mortality/therapy
Respiratory Insufficiency/prevention & control
Selection Bias
Subramaniam P
Treatment Failure