The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis
Background: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (...
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| Format: | Article |
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MDPI AG
2022-04-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/5/589 |
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| author | Carlos J. Toro-Huamanchumo Maryori M. Hilario-Gomez Nelson Diaz-Reyes José A. Caballero-Alvarado Joshuan J. Barboza |
| author_facet | Carlos J. Toro-Huamanchumo Maryori M. Hilario-Gomez Nelson Diaz-Reyes José A. Caballero-Alvarado Joshuan J. Barboza |
| author_sort | Carlos J. Toro-Huamanchumo |
| collection | DOAJ |
| description | Background: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (RCTs). We used relative risk (RR) and mean difference (MD) with 95% confidence intervals (95%CI) to assess the effect on dichotomous and continuous outcomes, respectively. In addition, we used the Paule–Mandel (PM) random effects model due to the anticipated lack of events. Results: Three RCTs were included (<i>n</i> = 432). No significant difference was found in mortality (RR = 0.82; 95%CI = 0.54–1.25; I<sup>2</sup> = 71%; <i>p</i> = 0.36), need for ventilation (RR = 0.49; 95%CI = 0.15–1.56; I<sup>2</sup> = 71%; <i>p</i> = 0.57), and incidence of pneumothorax (RR = 1.24; 95%CI = 0.30–5.12; I<sup>2</sup> = 0%; <i>p</i> = 0.77) in the CPAP group compared to the ETI group. Regarding secondary outcomes, compared to the ETI group, no significant differences were found in APGAR at one minute (MD = −1.01; 95%CI −2.97 to 0.94; I<sup>2</sup> = 98%; <i>p</i> = 0.31), APGAR at 5 min (MD = −1.00; 95%CI = −2.96 to 0.95; I<sup>2</sup> = 99%; <i>p</i> = 0.32), days of hospitalization (MD = −0.52; 95%CI = −1.46 to 0.42; I<sup>2</sup> = 94%; <i>p</i> = 0.28), and cord pH (MD = 0.003; 95%CI = −0.01 to 0.02; I<sup>2</sup> = 0%; <i>p</i> = 0.79). Conclusions: In patients with MAS, there is no significant effect of CPAP use compared to ETI on primary, specifically on mortality, need for ventilation, the incidence of pneumothorax, and secondary outcomes. |
| first_indexed | 2024-03-10T03:09:36Z |
| format | Article |
| id | doaj.art-5a2c6a450c1b419b98a72e73eacf8540 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T03:09:36Z |
| publishDate | 2022-04-01 |
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| series | Children |
| spelling | doaj.art-5a2c6a450c1b419b98a72e73eacf85402023-11-23T10:29:30ZengMDPI AGChildren2227-90672022-04-019558910.3390/children9050589The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-AnalysisCarlos J. Toro-Huamanchumo0Maryori M. Hilario-Gomez1Nelson Diaz-Reyes2José A. Caballero-Alvarado3Joshuan J. Barboza4Facultad de Ciencias de la Salud, Escuela de Medicina, Universidad César Vallejo, Trujillo 13007, PeruSociedad Científica de San Fernando, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima 15081, PeruEscuela de Medicina, Universidad Peruana Unión, Lima 15081, PeruEscuela de Postgrado, Universidad Privada Antenor Orrego, Trujillo 13007, PeruUnidad de Revisiones Sistemáticas y Meta-Análisis (URSIGET), Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola, Lima 15081, PeruBackground: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (RCTs). We used relative risk (RR) and mean difference (MD) with 95% confidence intervals (95%CI) to assess the effect on dichotomous and continuous outcomes, respectively. In addition, we used the Paule–Mandel (PM) random effects model due to the anticipated lack of events. Results: Three RCTs were included (<i>n</i> = 432). No significant difference was found in mortality (RR = 0.82; 95%CI = 0.54–1.25; I<sup>2</sup> = 71%; <i>p</i> = 0.36), need for ventilation (RR = 0.49; 95%CI = 0.15–1.56; I<sup>2</sup> = 71%; <i>p</i> = 0.57), and incidence of pneumothorax (RR = 1.24; 95%CI = 0.30–5.12; I<sup>2</sup> = 0%; <i>p</i> = 0.77) in the CPAP group compared to the ETI group. Regarding secondary outcomes, compared to the ETI group, no significant differences were found in APGAR at one minute (MD = −1.01; 95%CI −2.97 to 0.94; I<sup>2</sup> = 98%; <i>p</i> = 0.31), APGAR at 5 min (MD = −1.00; 95%CI = −2.96 to 0.95; I<sup>2</sup> = 99%; <i>p</i> = 0.32), days of hospitalization (MD = −0.52; 95%CI = −1.46 to 0.42; I<sup>2</sup> = 94%; <i>p</i> = 0.28), and cord pH (MD = 0.003; 95%CI = −0.01 to 0.02; I<sup>2</sup> = 0%; <i>p</i> = 0.79). Conclusions: In patients with MAS, there is no significant effect of CPAP use compared to ETI on primary, specifically on mortality, need for ventilation, the incidence of pneumothorax, and secondary outcomes.https://www.mdpi.com/2227-9067/9/5/589CPAPmeconium aspiration syndromenewbornssystematic review |
| spellingShingle | Carlos J. Toro-Huamanchumo Maryori M. Hilario-Gomez Nelson Diaz-Reyes José A. Caballero-Alvarado Joshuan J. Barboza The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis Children CPAP meconium aspiration syndrome newborns systematic review |
| title | The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis |
| title_full | The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis |
| title_fullStr | The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis |
| title_short | The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis |
| title_sort | efficacy of cpap in neonates with meconium aspiration syndrome a systematic review and meta analysis |
| topic | CPAP meconium aspiration syndrome newborns systematic review |
| url | https://www.mdpi.com/2227-9067/9/5/589 |
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