Ventilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis.

[en] ("[en] UNLABELLED: Initial management of inadequate adaptation to extrauterine life relies on non-invasive respiratory support. Two types of devices are available: fixed pressure devices (FPD; T-pieces or ventilators) and hand driven pressure devices (HDPD; self- or flow-inflating bags). This systematic review and meta-analysis aims to compare clinical outcomes after neonatal resuscitation according to device type. METHODS: Four databases were searched from inception to 2022, January. Search strategies included Mesh/Emtree terms as well as free language without any restriction. Randomized, quasi-randomized studies and prospective cohorts comparing the use of the two types of devices in neonatal resuscitation were included. RESULTS: Nine studies recruiting 3621 newborns were included: 5 RCTs, 2 RCTs with interventions bundles and 2 prospective cohorts. Meta-analysis of the 5 RCTs demonstrated significant reductions in bronchopulmonary dysplasia (RR0,68[0,48-0,96]-NNT 31) and other respiratory outcomes: intubation in the delivery room (RR0,72[0,58-0,88]-NNT 13,4), mechanical ventilation requirements (RR0,81[0,67-0,96]-NNT 17) and duration (MD-1,54 days[-3,03- -0,05]), need for surfactant (RR0,79[0,64-0,96]-NNT 7,3). The overall analysis found a lower mortality in the FPD group (OR0,57[0,47-0,69]-NNT 12,7) and confirmed decreases in intubation, surfactant requirement and mechanical ventilation rates (OR 0,56[0,40-0,79]- NNT7,5; OR 0,67[0,55-0,82]-NNT10,7 and OR0,58[0,42-0,80]- NNT 7,4 respectively). The risk of cystic periventricular leukomalacia (cPVL) decreased significantly with FPD (OR0.59[0.41-0.85]-NNT 27). Pneumothorax rates were similar (OR0.82[0.44-1.52]). CONCLUSION AND RELEVANCE: Resuscitation at birth with FPD improves respiratory transition and decreases BPD with a very low to moderate certainty of evidence. There is suggestion of decreases in mortality and cPVL. Further studies are still needed to confirm those results.","[en] ","")

Disciplines :

Pediatrics
Anesthesia & intensive care

Author, co-author :

Tribolet, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR)

HENNUY, Nadège ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR)

Rigo, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR) ; Université de Liège - ULiège > Département des sciences cliniques > Néonatologie

Language :

English

Title :

Ventilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis.

Alternative titles :

[fr] Dispositifs de ventilation pour la réanimation à la naissance: revue systématique et méta-analyse

Publication date :

06 January 2023

Journal title :

Resuscitation

ISSN :

0300-9572

eISSN :

1873-1570

Publisher :

Elsevier BV, Ireland

Volume :

183

Pages :

109681

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.resuscitationjournal.com/article/S0300-9572(22)00754-7/fulltext

Data Set :

https://www.resuscitationjournal.com/article/S0300-9572(22)00754-7/fulltext

Commentary :

Open access sur le site de l'éditeur. https://www.resuscitationjournal.com/article/S0300-9572(22)00754-7/fulltext

Available on ORBi :

since 02 June 2023

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