Cochrane · systematic review · CD013732
Opioids for newborn infants receiving mechanical ventilation
Bellù, R, Romantsik, O, Nava, C, et al. · Cochrane Database of Systematic Reviews · 2021 · 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
43
current version
GRADE rated
13
No studies
29
Included studies
NR
No studies 29 · 67.4%Ungraded 1 · 2.3%Very low 10 · 23.3%Low 1 · 2.3%Moderate 2 · 4.7%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
Opioids compared to placebo or no treatment for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP) ‐ time window: ≥ 12 and < 48 hours after infusion Opioids vs placebo or no treatment | no estimate extracted | 3 studies · 963 participants | Very low |
Duration of mechanical ventilation (days) Opioids vs placebo or no treatment | no estimate extracted | 7 studies · 1259 participants | Moderate |
Neonatal mortality Opioids vs placebo or no treatment | RR 1.12 [0.8, 1.55] | 5 studies · 1189 participants | Moderate |
Mortality to discharge Opioids vs placebo or no treatment | RR 0.99 [0.52, 1.88] | 4 studies · 178 participants | Low |
Neurodevelopmental outcomes (18 to 24 months) Opioids vs placebo or no treatment | RR 2 [0.39, 10.29] | 1 study · 78 participants | Very low |
Neurodevelopmental outcomes (3 to 5 years) Opioids vs placebo or no treatment | no estimate extracted | NR | No studies |
Neurodevelopmental outcome (5 to 6 years) Opioids vs placebo or no treatment | RR 1.6 [0.56, 4.56] | 1 study · 95 participants | Very low |
Opioids compared to other analgesics and sedatives for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP) Opioids vs other analgesics and sedatives | no estimate extracted | 1 study · 46 participants | Very low Downgraded: imprecision |
Duration of mechanical ventilation (days) Opioids vs other analgesics and sedatives | no estimate extracted | 1 study · 46 participants | Very low Downgraded: imprecision |
Neonatal mortality Opioids vs other analgesics and sedatives | RR 0.31 [0.01, 7.16] | 1 study · 46 participants | Very low Downgraded: imprecision |
Mortality before discharge Opioids vs other analgesics and sedatives | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (18 to 24 months) Opioids vs other analgesics and sedatives | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (3 to 5 years) Opioids vs other analgesics and sedatives | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (5 to 6 years) Opioids vs other analgesics and sedatives | no estimate extracted | NR | No studies |
Morphine compared to fentanyl for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP) Morphine vs fentanyl | no estimate extracted | NR | No studies |
Duration of mechanical ventilation (days) Morphine vs fentanyl | no estimate extracted | NR | No studies |
Neonatal mortality Morphine vs fentanyl | no estimate extracted | NR | No studies |
Mortality to discharge Morphine vs fentanyl | RR 1.21 [0.43, 3.45] | 1 study · 163 participants | Very low Downgraded: imprecision |
Neurodevelopmental outcomes (18 to 24 months)Â Morphine vs fentanyl | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (3 to 5 years) Morphine vs fentanyl | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (5 to 6 years) Morphine vs fentanyl | no estimate extracted | NR | No studies |
Morphine compared to diamorphine for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP)Â Morphine vs diamorphine | no estimate extracted | NR | No studies |
Duration of mechanical ventilation (days) Morphine vs diamorphine | no estimate extracted | NR | No studies |
Neonatal mortality Morphine vs diamorphine | RR 1.17 [0.43, 3.19] | 1 study · 88 participants | Very low Downgraded: imprecision |
Mortality before discharge Morphine vs diamorphine | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (18 to 24 months) Morphine vs diamorphine | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (3 to 5 years) Morphine vs diamorphine | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (5 to 6 years) Morphine vs diamorphine | no estimate extracted | NR | No studies |
Fentanyl compared to sufentanil for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP) Fentanyl vs sufentanil | no estimate extracted | NR | No studies |
Duration of mechanical ventilation (days) Fentanyl vs sufentanil | no estimate extracted | 1 study · 20 participants | Very low Downgraded: imprecision |
Neonatal mortality Fentanyl vs sufentanil | no estimate extracted | NR | Very low Downgraded: imprecision |
Mortality before discharge Fentanyl vs sufentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (18 to 24 months) Fentanyl vs sufentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (3 to 5 years) Fentanyl vs sufentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (5 to 6 years) Fentanyl vs sufentanil | no estimate extracted | NR | No studies |
Not estimable Fentanyl vs sufentanil | no estimate extracted | 95 participants | Ungraded |
Fentanyl compared to remifentanil for neonates receiving mechanical ventilation
Population: neonates receiving mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (PIPP) Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Duration of mechanical ventilation (days) Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Neonatal mortality Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Mortality before discharge Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (18 to 24 months) Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (3 to 5 years) Fentanyl vs remifentanil | no estimate extracted | NR | No studies |
Neurodevelopmental outcomes (5 to 6 years) Fentanyl vs remifentanil | no estimate extracted | NR | No studies |