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Supraglottic Airways Compared With Face Masks for Neonatal Resuscitation: A Systematic Review.
Pediatrics ( IF 6.2 ) Pub Date : 2022-09-01 , DOI: 10.1542/peds.2022-056568
Nicole K Yamada 1 , Christopher Jd McKinlay 2, 3 , Bin Huey Quek 4 , Georg M Schmölzer 5 , Myra H Wyckoff 6 , Helen G Liley 7 , Yacov Rabi 8 , Gary M Weiner 9
Affiliation  

BACKGROUND AND OBJECTIVES Positive pressure ventilation (PPV) is the most important component of neonatal resuscitation, but face mask ventilation can be difficult. Compare supraglottic airway devices (SA) with face masks for term and late preterm infants receiving PPV immediately after birth. METHODS Data sources include Medline, Embase, Cochrane Databases, Database of Abstracts of Reviews of Effects, and Cumulative Index to Nursing and Allied Health Literature. Study selections include randomized, quasi-randomized, interrupted time series, controlled before-after, and cohort studies with English abstracts. Two authors independently extracted data and assessed risk of bias and certainty of evidence. The primary outcome was failure to improve with positive pressure ventilation. When appropriate, data were pooled using fixed effect models. RESULTS Meta-analysis of 6 randomized controlled trials (1823 newborn infants) showed that use of an SA decreased the probability of failure to improve with PPV (relative risk 0.24; 95% confidence interval 0.17 to 0.36; P <.001, moderate certainty) and endotracheal intubation (4 randomized controlled trials, 1689 newborn infants) in the delivery room (relative risk 0.34, 95% confidence interval 0.20 to 0.56; P <.001, low certainty). The duration of PPV and time until heart rate >100 beats per minute was shorter with the SA. There was no difference in the use of chest compressions or epinephrine during resuscitation. Certainty of evidence was low or very low for most outcomes. CONCLUSIONS Among late preterm and term infants who require resuscitation after birth, ventilation may be more effective if delivered by SA rather than face mask and may reduce the need for endotracheal intubation.

中文翻译:

声门上气道与新生儿复苏面罩的比较:系统评价。

背景和目标 正压通气 (PPV) 是新生儿复苏最重要的组成部分,但面罩通气可能很困难。比较声门上气道装置 (SA) 与面罩对出生后立即接受 PPV 的足月和晚期早产儿的影响。方法 数据来源包括 Medline、Embase、Cochrane 数据库、效果评价摘要数据库以及护理和相关健康文献的累积索引。研究选择包括随机、准随机、间断时间序列、前后对照和带有英文摘要的队列研究。两位作者独立提取数据并评估偏倚风险和证据的确定性。主要结果是正压通气未能改善。适当时,使用固定效应模型汇总数据。结果 对 6 项随机对照试验(1823 名新生儿)的荟萃分析表明,使用 SA 可降低 PPV 改善失败的可能性(相对风险 0.24;95% 置信区间 0.17 至 0.36;P <.001,中等确定性)和产房气管插管(4 项随机对照试验,1689 名新生儿)(相对风险 0.34,95% 置信区间 0.20 至 0.56;P <.001,低确定性)。SA的PPV持续时间和心率> 100次/分钟的时间更短。在复苏期间使用胸外按压或肾上腺素没有差异。大多数结果的证据质量低或非常低。结论 在出生后需要复苏的晚期早产儿和足月儿中,
更新日期:2022-08-11
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