Cochrane · systematic review · CD008309
Laryngeal mask airway surfactant administration for prevention of morbidity and mortality in preterm infants with or at risk of respiratory distress syndrome
Abdel-Latif, ME, Walker, E, Osborn, DA · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
NeonatalAMSTAR 2: not assessed
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
21
current version
GRADE rated
16
No studies
5
Included studies
NR
No studies 5 · 23.8%Ungraded 0 · 0%Very low 6 · 28.6%Low 9 · 42.9%Moderate 1 · 4.8%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
Surfactant administration via laryngeal mask airway (S‐LMA) versus surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE)
Population: preterm infants with or at risk of respiratory distress syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | RR 1.5 [0.27, 8.34] | 2 studies · 110 participants | Low Downgraded: imprecision |
Mechanical ventilation at any time Any time to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | RR 0.53 [0.36, 0.78] | 5 studies · 333 participants | Low Downgraded: imprecision, inconsistency |
Pulmonary air leak, any (during first hospitalisation) Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | RR 1.39 [0.65, 2.98] | 5 studies · 333 participants | Low Downgraded: imprecision |
Bronchopulmonary dysplasia (clinical definition) among survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | RR 1.28 [0.47, 3.52] | 4 studies · 264 participants | Low Downgraded: imprecision |
Intraventricular haemorrhage grade III and IV Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, inconsistency |
Death (all causes) during the first hospitalisation Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | RR 0.28 [0.01, 6.6] | 3 studies · 203 participants | Low Downgraded: imprecision |
Neurosensory disability in survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with the intent to rapidly extubate (InSurE) | no estimate extracted | NR | No studies |
Surfactant administration via laryngeal mask airway (S‐LMA) versus surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT)
Population: preterm infants with or at risk of respiratory distress syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | no estimate extracted | NR | No studies |
Mechanical ventilation at any time Any time to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | RR 0.47 [0.31, 0.71] | 1 study · 48 participants | Low Downgraded: imprecision, inconsistency |
Pulmonary air leak, any (during first hospitalisation) Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | RR 2.56 [0.11, 59.75] | 1 study · 48 participants | Very low Downgraded: imprecision, inconsistency |
Bronchopulmonary dysplasia (clinical definition) among survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | no estimate extracted | NR | No studies |
Intraventricular haemorrhage grade III and IV Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | RR 2.56 [0.11, 59.75] | 1 study · 48 participants | Very low Downgraded: imprecision, inconsistency |
Death (all causes) during the first hospitalisation Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | RR 0.17 [0.01, 3.37] | 1 study · 48 participants | Very low Downgraded: imprecision, inconsistency |
Neurosensory disability in survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs surfactant administration via endotracheal tube (ETT) with extubation at standard criteria (S‐ETT) | no estimate extracted | NR | No studies |
Surfactant administration via laryngeal mask airway (S‐LMA) versus no surfactant administration
Population: preterm infants with or at risk of respiratory distress syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | RR 1.65 [0.85, 3.22] | 2 studies · 129 participants | Low Downgraded: imprecision, inconsistency |
Mechanical ventilation at any time At any time to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | RR 0.57 [0.38, 0.85] | 2 studies · 129 participants | Moderate Downgraded: imprecision |
Pulmonary air leak, any (during first hospitalisation) Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | RR 0.65 [0.23, 1.88] | 2 studies · 129 participants | Low Downgraded: imprecision |
Bronchopulmonary dysplasia (clinical definition) among survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | RR 1.65 [0.85, 3.22] | 2 studies · 129 participants | Low Downgraded: imprecision, inconsistency |
Intraventricular haemorrhage grade III and IV Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | no estimate extracted | 1 study · 103 participants | Very low Downgraded: imprecision, inconsistency |
Death (all causes) during the first hospitalisation Anytime to discharge Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | no estimate extracted | 1 study · 103 participants | Very low Downgraded: imprecision, inconsistency |
Neurosensory disability in survivors Surfactant administration via laryngeal mask airway (S‐LMA) vs no surfactant administration | no estimate extracted | NR | No studies |