期刊
TRANSLATIONAL PEDIATRICS
卷 11, 期 7, 页码 1242-1250出版社
AME PUBLISHING COMPANY
DOI: 10.21037/tp-22-288
关键词
Nasal intermittent positive pressure ventilation; nasal continuous positive airway pressure ventilation; respiratory distress syndrome
类别
Compared to NCPAP, NIPPV can reduce the incidence of intubation, BPD, and mortality in neonatal respiratory distress syndrome (RDS). These conclusions need to be confirmed via high-quality randomized controlled trials (RCTs).
Background: The efficacies of nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) in neonatal respiratory distress syndrome (RDS) are controversial. The reasons for controversy may be the selection bias of research objects and the small sample size. Methods: Literature retrieval was performed in PubMed, EMBASE, Medline, Central, China National Knowledge Infrastructure (CNKI), Wanfang and China Science Digital Library (CSDL) databases. Inclusion criteria: (I) literatures involving subjects who were newborns with RDS; (II) studies that had established both experimental and control groups; (III) the intervention measures of the experimental and control groups were NIPPV and NCPAP, respectively; (IV) the results included the incidence of intubation, bronchopulmonary dysplasia (BPD), or mortality; and (V) randomized controlled trials (RCTs). The chisquare test was applied for heterogeneity test. Publication bias assessment was conducted by funnel plot and Egger's test. The revised Cochrane risk of bias tool for individually randomized, parallel group trials (RoB2.0) was used to evaluate the risk of bias of the included RCT research. Results: A total of 10 literatures were included for analysis, including 1,104 patients, 557 in the NIPPV group and 547 in the NCPAP group. Among the literatures, 2 literatures had low risk of bias, 2 literatures had high risk of bias, and the rest had uncertain risk of bias. Compared to NCPAP, NIPPV reduced the incidence of neonatal intubation in RDS [risk ratio (RR) =0.57, 95% confidence interval (CI): 0.46-0.71, Z=5.11, P<0.00001]. There was no statistically significant heterogeneity (P=0.13, I2=36%) or publication bias (P<0.05) among the studies. Compared with NCPAP, NIPPV reduced the incidence of BPD in RDS (RR =0.72, 95% CI: 0.57-0.91, Z=2.70, P=0.007). There was no statistically significant heterogeneity (P=0.10, I2=41%) or publication bias (P>0.05) among the studies. NIPPV reduced the neonatal mortality rate of RDS (RR =0.55, 95% CI: 0.31-0.97, Z=2.08, P=0.04). There was no statistically significant heterogeneity (P=0.20, I2=38%) or publication bias (P>0.05) among the studies. Discussion: Compared with NCPAP, NIPPV can reduce the incidence of intubation, BPD, and mortality. The conclusions need to be confirmed via high-quality RCTs.
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