选择性高频振荡与早产婴儿常规通风相比:对个体患者数据的系统审查和元分析
Filip Cools1, Lisa M Askie, Martin Offringa
1Neonatal Intensive Care Unit, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. filip.cools@uzbrussel.be
Lancet (London, England)
|June 17, 2010
概括
高频振荡通风 (HFOV) 显示出与早产婴儿常规通风效果相似的效果. 基于妊娠年龄或出生体重等特定因素的患者选择并未得到当前证据的支持.
科学领域:
- 新生儿医学 新生儿医学
- 儿科呼吸系统护理 儿童呼吸系统护理
- 临床试验和元分析
背景情况:
- 之前关于早产婴儿高频振荡通风 (HFOV) 的元分析被异质性所困惑.
- 与传统通风相比,选择性HFOV的有效性和安全性存在不确定性.
研究的目的:
- 评估选用高频振荡通风 (HFOV) 与早产婴儿常规通风的有效性.
- 为了澄清HFOV在新生儿呼吸支中的作用.
主要方法:
- 系统审查和对个别患者数据的元分析.
- 包括来自10个随机对照试验的3229名参与者的数据.
- 主要结局包括36周月经后的死亡或支气管肺形,以及死亡或严重的神经不良事件.
主要成果:
- 在36周的月经后,HFOV显示死亡或支气管肺功能障碍的相对风险为0.95 (95% CI 0.88-1.03).
- 在死亡或严重的神经不良事件方面没有发现显著差异 (RR 1.00;95% CI 0.88-1.13).
- 没有特定的婴儿子组 (妊娠年龄,出生体重,肺部疾病严重程度,产前皮质类固醇) 显示HFOV的差异效益.
结论:
- 高频振荡通风 (HFOV) 似乎与早产婴儿的常规通风同样有效.
- 目前的证据不支持根据妊娠年龄,出生体重,肺部疾病严重程度或产前皮质类固醇暴露,为HFOV选择早产婴儿.
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