NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Clin Perinatol. 2019 Sep;46(3):621-636. doi: 10.1016/j.clp.2019.05.015. Epub 2019 Jun 12.
This narrative review identified 23 publications in 2011 to 2019 discussing randomized trials of oxygen saturation targets of 85% to 89% versus 91% to 95% in infants below 28 weeks' gestation. Of 18 commentaries or consensus statements, 17 recommended saturation targets above 89%. Five systematic reviews reported that the 85% to 89% target increased mortality but not the composite of death or disability. The evidence for increased mortality was assessed as of "high", "moderate," or "low," quality, reflecting substantial differences in interpreting the GRADE guidelines. Systematic reviews and guidelines without biostatisticians or epidemiologists as co-authors should be considered potentially problematic.
这篇综述性文章在 2011 年至 2019 年期间共识别出 23 篇讨论早产儿(胎龄小于 28 周)氧饱和度目标值为 85%至 89%与 91%至 95%的随机试验的文献。在 18 篇评论或共识声明中,有 17 篇建议将饱和度目标定在 89%以上。五项系统评价报告称,目标值为 85%至 89%会增加死亡率,但不会增加死亡或残疾的复合率。对于增加死亡率的证据评估为“高”、“中”或“低”质量,这反映了在解释 GRADE 指南方面存在很大差异。没有生物统计学家或流行病学家作为合著者的系统评价和指南应被视为可能存在问题。