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Surfactant lavage therapy for meconium aspiration syndrome: a systematic review and meta-analysis

Authors
 Hyun Jin Choi  ;  Seokyung Hahn  ;  Joongyub Lee  ;  Byung-Joo Park  ;  Soon Min Lee  ;  Han-Suk Kim  ;  Chong-Woo Bae 
Citation
 Neonatology, Vol.101(3) : 183-191, 2012 
Journal Title
 Neonatology 
ISSN
 1661-7800 
Issue Date
2012
Abstract
BACKGROUND: Lung lavage with diluted surfactant has emerged as an innovative treatment for meconium aspiration syndrome (MAS). However, the treatment effect has not yet been fully established. OBJECTIVE: To investigate the effects of surfactant lavage therapy for MAS by a systematic meta-analysis. METHODS: Relevant studies were identified by database searches in MEDLINE (from 1950), EMBASE (from 1980), and CENTRAL, up to June 2010, and by additional hand searches. Meta-analyses were separately conducted for randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs). Risk of bias was assessed and clinical as well as statistical heterogeneities were also investigated in explaining the potential bias. RESULTS: Two RCTs (87 patients) and eight NRSs (178 patients) were identified. From the results of the meta-analysis of RCTs, surfactant lavage significantly decreased death or the need for extracorporeal membrane oxygenation (RR 0.34, 95% CI 0.11, 0.99). An interventional benefit was indicated for other outcomes, although it was not statistically significant based only on the two RCTs. Results from the analysis of outcomes from NRSs are consistent with those from RCTs and demonstrated a beneficial effect, which could be considered as supporting evidence. CONCLUSIONS: Lung lavage with diluted surfactant appeared to improve the clinical outcome in infants with MAS. Given that less than 100 infants were included in the two RCTs, the findings of this study may still be regarded as insufficient evidence. Further research will be needed to confirm the benefit as well as to refine the lavage technique.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91509
DOI
10.1159/000329822
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
이순민(Lee, Soon Min)
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