Nasal Cannula with Long and Narrow Tubing for Non-Invasive Respiratory Support in Preterm Neonates: A Systematic Review and Meta-Analysis

被引:2
|
作者
Anand, Pratima [1 ,2 ]
Kaushal, Monika [3 ]
Ramaswamy, Viraraghavan Vadakkencherry [4 ]
Pullattayil, Abdul Kareem S. [5 ]
Razak, Abdul [6 ,7 ]
Trevisanuto, Daniele [8 ]
机构
[1] Vardhman Mahavir Med Coll, Dept Paediat, Div Neonatol, New Delhi 110029, India
[2] Safdarjang Hosp, New Delhi 110029, India
[3] Emirates Special Hosp, Dept Neonatol, POB 505240, Dubai, U Arab Emirates
[4] Ankura Hosp Women & Children, Dept Neonatol, Hyderabad 520072, India
[5] Queens Univ, Hlth Sci Lib, Kingston, ON K7L 3N6, Canada
[6] Princess Nourah Bint Abdulrahman Univ, King Abdullah Bin Abdulaziz Univ Hosp, Dept Paediat, Div Neonatol, Riyadh 11564, Saudi Arabia
[7] Monash Univ, Dept Paediat, Clayton, Vic 3800, Australia
[8] Univ Padua, Univ Hosp Padua, Dept Woman & Child Hlth, I-35128 Padua, Italy
来源
CHILDREN-BASEL | 2022年 / 9卷 / 10期
关键词
nasal cannula; neonate; noninvasive respiratory support; preterm infant; respiratory distress; systematic review; POSITIVE-PRESSURE VENTILATION; AIRWAY PRESSURE; QUALITY; INFANTS; INJURY; CPAP;
D O I
10.3390/children9101461
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Cannulas with long and narrow tubing (CLNT) are increasingly being used as an interface for noninvasive respiratory support (NRS) in preterm neonates; however, their efficacy compared to commonly used nasal interfaces such as short binasal prongs (SBP) and nasal masks (NM) has not been widely studied. Material and Methods: Medline, Embase, CENTRAL, Health Technology Assessment Database, and Web of Science were searched for randomized clinical trials (RCTs) and observational studies investigating the efficacy of CLNT compared to SBP or NM in preterm neonates requiring NRS for primary respiratory and post-extubation support. A random-effects meta-analysis was used for data synthesis. Results: Three RCTs and three observational studies were included. Clinical benefit or harm could not be ruled out for the outcome of need for invasive mechanical ventilation (IMV) for CLNT versus SBP or NM [relative risk (RR) 1.37, 95% confidence interval (CI) 0.61-3.04, certainty of evidence (CoE) low]. The results were also inconclusive for the outcome of treatment failure [RR 1.20, 95% CI 0.48-3.01, CoE very low]. Oropharyngeal pressure transmission was possibly lower with CLNT compared to other interfaces [MD -1.84 cm H20, 95% CI -3.12 to -0.56, CoE very low]. Clinical benefit or harm could not be excluded with CLNT compared to SBP or NM for the outcomes of duration of IMV, nasal trauma, receipt of surfactant, air leak, and NRS duration. Conclusion: Very low to low CoE and statistically nonsignificant results for the clinical outcomes precluded us from making any reasonable conclusions; however, the use of CLNT as an NRS interface, compared to SBP or NM, possibly transmits lower oropharyngeal pressures. We suggest adequately powered multicentric RCTs to evaluate the efficacy of CLNT when compared to other interfaces.
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页数:14
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