Anabrees Jasim A, Aifaleh Khalid M
Neonatal Care, Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia.
J Clin Neonatol. 2012 Jan;1(1):1-5. doi: 10.4103/2249-4847.92228.
Although survival of extremely low birth weight (ELBW) infants dramatically improved over last decades, bronchopulmonary dysplasia (BPD) rate has not changed. The use of indomethacin prophylaxis in ELBW infants results in improved short-term outcomes with no effect on long-term outcomes. The addition of fluid restriction to the indomethacin prophylaxis policy could result in a reduction of BPD and improve long-term survival without neurosensory impairment at 18 months corrected age. To determine the effect of a policy of fluid restriction compared with a policy of no fluid restriction on morbidity and mortality in ELBW infants receiving indomethacin prophylaxis. The standard search strategy for the Cochrane Neonatal Review Group was used. This included search of OVID MEDLINE-National Library of Medicine, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 8, 2011). Additional search included conference proceedings, references in articles, and unpublished data. All randomized or quasi-randomized trials that compared fluid restriction and indomethacin prophylaxis vs. indomethacin prophylaxis alone in ELBW infants were included. Standard methods of the Cochrane Neonatal Review Group were planned to assess the methodological quality of the trials. Review Manager 5 software was planned to be used for statistical analysis. We found no randomized controlled trials to investigate the possible interaction between fluid restriction and indomethacin prophylaxis vs. indomethacin prophylaxis alone in ELBW infants. A well-designed randomized trial is needed to address this question.
尽管极低出生体重（ELBW）婴儿的存活率在过去几十年中有了显著提高，但支气管肺发育不良（BPD）的发生率并未改变。对ELBW婴儿使用吲哚美辛预防可改善短期结局，对长期结局无影响。在吲哚美辛预防方案中增加液体限制可降低BPD的发生率，并提高18个月矫正年龄时无神经感觉障碍的长期存活率。为了确定与无液体限制方案相比，液体限制方案对接受吲哚美辛预防的ELBW婴儿发病率和死亡率的影响。采用了Cochrane新生儿综述组的标准检索策略。这包括检索OVID MEDLINE-美国国立医学图书馆、EMBASE以及Cochrane对照试验中央注册库（CENTRAL，《Cochrane图书馆》，2011年第8期）。额外的检索包括会议论文集、文章中的参考文献以及未发表的数据。纳入了所有比较液体限制加吲哚美辛预防与单独使用吲哚美辛预防对ELBW婴儿影响的随机或半随机试验。计划采用Cochrane新生儿综述组的标准方法来评估试验的方法学质量。计划使用Review Manager 5软件进行统计分析。我们未发现有随机对照试验来研究在ELBW婴儿中液体限制与吲哚美辛预防联合使用与单独使用吲哚美辛预防之间可能存在的相互作用。需要进行一项设计良好的随机试验来解决这个问题。
