Cochrane · systematic review · CD004953
Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes
Bruschettini, M, O'Donnell, CPF, Davis, PG, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 3 · 21.4%Very low 4 · 28.6%Low 3 · 21.4%Moderate 4 · 28.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyUse of initial sustained inflation compared to standard inflations in newborns receiving resuscitation with no chest compressions for
Population: preterm infants resuscitated by PPV at birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death ‒in the delivery room Use of initial sustained inflation vs standard inflations | RR 2.66 [0.11, 63.4] | 5 studies · 479 participants | Low Downgraded: risk of bias, imprecision |
Death ‒before discharge Use of initial sustained inflation vs standard inflations | RR 1.09 [0.83, 1.43] | 9 studies · 1458 participants | Moderate Downgraded: risk of bias, imprecision |
Rate of mechanical ventilation Use of initial sustained inflation vs standard inflations | RR 0.89 [0.77, 1.02] | 4 studies · 910 participants | Moderate Downgraded: risk of bias, imprecision |
Chronic lung disease ‒any grade Use of initial sustained inflation vs standard inflations | RR 0.98 [0.84, 1.13] | 8 studies · 1418 participants | Moderate Downgraded: risk of bias, imprecision |
Chronic lung disease ‒moderate to severe BPD Use of initial sustained inflation vs standard inflations | RR 0.95 [0.74, 1.22] | 5 studies · 683 participants | Moderate Downgraded: risk of bias, imprecision |
Pneumothorax Use of initial sustained inflation vs standard inflations | RR 0.89 [0.57, 1.39] | 9 studies · 1458 participants | Low Downgraded: risk of bias, imprecision |
Cranial ultrasound abnormalities ‒Intraventricular haemorrhage grade 3 to 4 Use of initial sustained inflation vs standard inflations | RR 0.85 [0.56, 1.28] | 6 studies · 735 participants | Low Downgraded: risk of bias, imprecision |
Use of initial sustained inflation for
Population: infants below 33 weeks of postmenstrual age who required resuscitation in the delivery room
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death ‒in the delivery room | no estimate extracted | 1 study · 9 participants | Ungraded |
Death ‒before discharge | RR 4.17 [0.25, 68.16] | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Rate of mechanical ventilation | no estimate extracted | 1 study · 9 participants | Ungraded |
Chronic lung disease ‒any grade | no estimate extracted | 1 study · 9 participants | Ungraded |
Chronic lung disease ‒moderate to severe BPD | RR 0.89 [0.33, 2.37] | 1 study · 7 participants | Very low Downgraded: risk of bias, imprecision |
Pneumothorax ‒at any time | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Cranial ultrasound abnormalities ‒intraventricular haemorrhage grade 3 to 4 | RR 0.4 [0.05, 2.98] | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Use of initial sustained inflation compared with standard inflations in newborns receiving resuscitation with no chest compressions during resuscitation
Population: preterm infants resuscitated using PPV at birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death ‐ death in the delivery room Use of initial sustained inflation vs standard inflations | RR 2.66 [0.11, 63.4] | 5 studies · 479 participants | Low Downgraded: risk of bias, imprecision |
Death ‐ death before discharge Use of initial sustained inflation vs standard inflations | RR 1.01 [0.67, 1.51] | 7 studies · 932 participants | Moderate Downgraded: risk of bias, imprecision |
Need for mechanical ventilation Use of initial sustained inflation vs standard inflations | RR 0.87 [0.74, 1.03] | 3 studies · 484 participants | Moderate Downgraded: risk of bias, imprecision |
Chronic lung disease ‐ BPD any grade Use of initial sustained inflation vs standard inflations | RR 0.9 [0.69, 1.19] | 2 studies · 220 participants | Moderate Downgraded: risk of bias, imprecision |
Chronic lung disease ‐ moderate to severe BPD Use of initial sustained inflation vs standard inflations | RR 0.95 [0.74, 1.22] | 5 studies · 683 participants | Moderate Downgraded: risk of bias, imprecision |
Pneumothorax ‐ any time Use of initial sustained inflation vs standard inflations | RR 1.44 [0.76, 2.72] | 6 studies · 851 participants | Low Downgraded: risk of bias, imprecision |
Cranial ultrasound abnormalities ‐ intraventricular haemorrhage grade 3 to 4 Use of initial sustained inflation vs standard inflations | RR 0.89 [0.58, 1.37] | 5 studies · 635 participants | Moderate Downgraded: risk of bias, imprecision |
Use of initial sustained inflation compared with standard inflations in newborns receiving resuscitation with chest compressions during resuscitation
Population: preterm infants resuscitated by PPV at birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death ‐ death before discharge Use of initial sustained inflation vs standard inflations | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Chronic lung disease ‐ moderate to severe BPD Use of initial sustained inflation vs standard inflations | no estimate extracted | 1 study · 7 participants | Very low Downgraded: risk of bias, imprecision |
Pneumothorax ‐ any time Use of initial sustained inflation vs standard inflations | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Cranial ultrasound abnormalities ‐ intraventricular haemorrhage grade 3 to 4 Use of initial sustained inflation vs standard inflations | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |