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태변흡인증후군에서 폐표면활성제 사용이 호흡기지표에 미치는 영향에 대한 체계적 문헌고찰과 메타분석

Other Titles
 The Effect on Pulmonary Indices of Surfactant Therapy for Meconium Aspiration Syndrome: Systematic Review and Meta-analysis 
Authors
 이순민 
Citation
 Journal of the Korean Society of Neonatology (대한신생아학회지), Vol.18(2) : 189~196, 2011 
Journal Title
 Journal of the Korean Society of Neonatology (대한신생아학회지) 
ISSN
 1226-1513 
Issue Date
2011
Abstract
PURPOSE: Surfactants have been used to improve oxygenation for infants with meconium aspiration syndrome (MAS). We evaluated the change of pulmonary indices after surfactant therapy for MAS through a systematic meta-analysis. METHODS: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to June 2011, and by additional hand searches. Data were extracted regarding pulmonary indices, such as the oxygen index and arterial alveolar oxygen gradient. Meta-analyses were separately conducted for the studies of surfactant lavage therapy and surfactant bolus therapy. The risk of bias was assessed, and clinical as well as statistical heterogeneities were also investigated. RESULTS: Two RCTs for bolus surfactant therapy and two RCTs for surfactant lavage therapy were identified. The oxygenation index results were heterogeneous between the two studies in which bolus surfactant therapy was given, while a/A PO2 showed significantly better results in the treatment group over time after use of surfactant (12 hours: WMD 0.08, 95% CI 0.04-0.12; 24 hours: WMD 0.17, 95% CI 0.06-0.28). For surfactant lavage therapy, both studies consistently suggested an interventional benefit in terms of the pulmonary indices although it did not reach statistical significance. CONCLUSION: Surfactant therapy appeared to improve oxygenation of infants with MAS. Since a limited number of RCTs are available in the current literature and those studies were also clinically heterogeneous in terms of illness severity and the method of surfactant use, further research is needed to gather evidence to support surfactant therapy in MAS
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94842
DOI
10.5385/jksn.2011.18.2.189
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Pediatrics
Yonsei Authors
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