NDLI: Does surfactant nebulization prevent early intubation in preterm infants? A protocol for a systematic review and meta-analysis

Content Provider	Springer Nature : BioMed Central
Author	Gaertner, Vincent D. Bassler, Dirk Rüegger, Christoph M.
Abstract	Background Respiratory distress syndrome (RDS) is the most common cause of respiratory failure in preterm infants. Treatment consists of respiratory support and exogenous surfactant administration. Commonly, surfactant is administered intratracheally. However, this requires airway instrumentation and subsequent fluid instillation which may be harmful. Surfactant nebulization (SN) may offer a safe and effective alternative for surfactant administration, but the clinical efficacy is not yet established. Thus, this systematic review and meta-analysis of randomized controlled trials will summarize the available evidence to determine the effectiveness and safety of SN for the prevention of intubation and subsequent mechanical ventilation at 72 h after birth. Methods A systematic literature search in Medline, Embase, and The Cochrane Library will be performed, and all randomized controlled trials (RCTs) and quasi-RCTs from published articles, presentations, and trial registries will be included in this meta-analysis. Titles and abstracts of all records identified in the search will be screened by two reviewers independently. Data on preterm infants (≤ 37 weeks) receiving nebulized surfactant in the first 72 h after birth for the treatment or prevention of RDS will be evaluated. Primary outcome is the intubation rate by 72 h after birth, and secondary outcomes include peridosing safety effects as well as major neonatal morbidities. Risk of bias will be assessed using the revised Cochrane ROB tool, and subgroup analyses will be performed to evaluate potential confounding factors. Publication bias will be assessed by examining a funnel plot. The meta-analysis will be performed using a fixed-effects model. Discussion This review will provide an evidence-based tool for information about surfactant nebulization, illustrating the current knowledge and hopefully revealing potential novel avenues for researchers and clinicians alike. Systematic review registration This review is registered with the publicly available resource PROSPERO ( CRD42020175625 ).
Related Links	https://systematicreviewsjournal.biomedcentral.com/counter/pdf/10.1186/s13643-020-01573-6.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
ISSN	20464053
DOI	10.1186/s13643-020-01573-6
Journal	Systematic Reviews
Issue Number	1
Volume Number	10
Language	English
Publisher	BioMed Central
Publisher Date	2021-01-06
Access Restriction	Open
Subject Keyword	Medicine Public Health Biomedicine Statistics for Life Sciences Health Sciences Nebulized surfactant Delivery room Respiratory distress syndrome Bronchopulmonary dysplasia Aerosolized surfactant Surfactant nebulization Surfactant aerosolization Meta-analysis Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Medicine
Journal Impact Factor	6.3/2023
5-Year Journal Impact Factor	4.5/2023

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