Lung recruitment manoeuvres for reducing mortality and respiratory morbidity in mechanically ventilated neonates
Blazek, E. V., East, C. E., Jauncey-Cooke, J., Bogossian, F., Grant, C. A. and Hough, J.. (2021). Lung recruitment manoeuvres for reducing mortality and respiratory morbidity in mechanically ventilated neonates. Cochrane Database of Systematic Reviews. 3, pp. 1-42. https://doi.org/10.1002/14651858.CD009969.pub2.
|Authors||Blazek, E. V., East, C. E., Jauncey-Cooke, J., Bogossian, F., Grant, C. A. and Hough, J.|
Data collection and analysis
Two studies enrolling 44 participants on CMV for respiratory distress syndrome compared a stepwise LRM with positive end‐expiratory pressure (PEEP) to routine care. Meta‐analysis demonstrated no evidence of a difference between the LRM and routine care on mortality by hospital discharge (RR 1.00, 95% CI 0.17 to 5.77; low‐certainty evidence), incidence of bronchopulmonary dysplasia (RR 0.25, 95% CI 0.03 to 2.07; low‐certainty evidence), duration of supplemental oxygen (MD ‐7.52 days, 95% CI ‐20.83 to 5.78; very low‐certainty evidence), and duration of ventilatory support (MD ‐3.59 days, 95% CI ‐12.97 to 5.79; very low‐certainty evidence). The certainty of the evidence for these outcomes was downgraded due to risk of bias, imprecision, and inconsistency. Whilst these studies contributed data to four of our primary outcomes, we were unable to identify any studies that reported our other primary outcomes: duration of continuous positive airway pressure therapy, duration of neonatal intensive care unit stay, and duration of hospital stay.
The third study that contributed data to the review enrolled 12 participants on CMV for respiratory and non‐respiratory causes, and compared two different LRMs applied after endotracheal tube suctioning to routine care. It was determined that both LRMs may slightly improve end‐expiratory lung volume at 120 minutes' post‐suctioning, when compared to routine care (incremental PEEP LRM versus routine care: MD ‐0.21, 95% CI ‐0.37 to ‐0.06; double PEEP LRM versus routine care: MD ‐0.18, 95% CI ‐0.35 to ‐0.02). It was also demonstrated that a double PEEP LRM may slightly reduce mean arterial pressure at 30 minutes' post‐suctioning, when compared with routine care (MD ‐16.00, 95% CI ‐29.35 to ‐2.65).
|Journal||Cochrane Database of Systematic Reviews|
|Journal citation||3, pp. 1-42|
|Publisher||John Wiley & Sons, Ltd|
|Digital Object Identifier (DOI)||https://doi.org/10.1002/14651858.CD009969.pub2.|
|Research or scholarly||Research|
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File Access Level
|Online||29 Mar 2021|
|Publication process dates|
|Deposited||18 Nov 2021|
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