Intubation-Surfactant-Extubation Strategy in a Medical Resource-limited Department: A Prospective Study

Azzabi, O.; Selmi, I.; Bellali, H.; Siala, N.; Dridi, Y.; Fetni, I.; Chahed, Mohamed Kouni; Halioui, S.; Maherzi, A.

doi:10.1093/tropej/fmv074

Cited by 1 publication

(7 citation statements)

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“…The full-text of 56 articles was assessed for eligibility. Finally, fifteen original studies met inclusion criteria [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Eight studies adjusted for possible confounding in a multivariate analysis, although the statistical methods were not always clearly described. After detailed quality assessment we categorized 4 studies as being high quality studies [16,17,19,26], 7 studies as being of acceptable quality [14,18,[20][21][22][23]28], and 4 studies as having a low methodological quality [15,24,25,27].…”

Section: Study Quality Assessmentmentioning

confidence: 99%

“…All studies evaluated BW as a potential predictive factor (Appendix 1). In 10 studies, a significantly lower BW was found in infants who failed INSURE [14,15,17,18,[20][21][22][23][24]27], whereas in one study the association was in the opposite direction [26]. Only 7 studies investigated the predictive value of BW in a multivariate analysis (total of 739 patients) [16][17][18][19]21,23,26] of which 2 found a significant association.…”

Section: Birth Weight (Bw)mentioning

confidence: 99%

“…All but one study investigated GA as a possible predictor for INSURE failure [15] (Appendix 2). In 7 out of the 15 studies, a significantly lower GA was found in infants who failed INSURE as compared to those who succeeded [14,18,20,22,24,27,28].…”

Section: Gestational Age (Ga)mentioning

confidence: 99%

“…Six studies evaluated fractional inspired oxygen concentration (FiO2) before INSURE procedure [14][15][16]19,20,25], which was significantly higher in infants who failed as compared to infants who succeeded INSURE in 3 studies [15,19,20]. In multivariate analysis (362 patients), a significant association was found in only one low quality study [15].…”

Section: Arterial Blood Gas Analysismentioning

confidence: 99%

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Early Predictors for INtubation-SURfactant-Extubation Failure in Preterm Infants with Neonatal Respiratory Distress Syndrome: A Systematic Review

Bisschop¹,

Derriks²,

Cools³

2019

Neonatology

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The INtubation-SURfactant-Extubation (INSURE) procedure is a widely-used surfactant administration method to treat preterm infants with respiratory distress syndrome (RDS) but is not always successful. We conducted a systematic review to identify early predictive factors for failure of this procedure. A systematic literature search was performed until July 2018 in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Original studies comparing INSURE success with INSURE failure in preterm infants with RDS were included. A predefined data extraction form was used to retrieve data from articles, and methodological quality was assessed using the SIGN checklists. Fifteen studies out of 690 identified records met inclusion criteria. Methodological quality varied, only 8 studies performed multivariate analysis. We identified 20 different risk factors in total. Evidence for birth weight (BW) as a predictor for INSURE failure was inconsistent, but there was a significant association between decreasing gestational age (GA) and failure risk. RDS severity was assessed in multiple ways, using arterial blood gas values, imaging, and scoring systems. In conclusion, extremely low BW, low GA, and severe RDS appear to be risk factors for INSURE failure. However, evidence is inconsistent due to important methodological heterogeneity. Therefore, clinical applicability of these results is limited and implies the need for future large cohort studies on this subject.

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