College of Pharmacy, QU Health, Qatar University, Doha 2713, Qatar.
Pharmacy Department, Hamad Medical Corporation, Doha, Qatar.
J Comp Eff Res. 2020 Jun;9(8):527-536. doi: 10.2217/cer-2020-0018. Epub 2020 May 12.
To conduct a systematic overview of systematic reviews (SRs) and randomized clinical trials (RCTs) on surfactant therapy in neonatal meconium aspiration syndrome. We searched EMBASE, PROQUEST and PubMed to summarize the different effects of surfactant lung lavage and bolus surfactant therapies in neonates with meconium aspiration syndrome. With a total of 1377 patients, three SRs and two RCTs were included in analysis. Surfactant effectiveness was concluded by low-quality SRs, with high risk of bias, which was contradicted by high-quality SRs, with low risk of bias. In SRs, the surfactant lung lavage reduced mortality, need for extracorporeal membrane oxygenation and hospitalization, while the bolus surfactant did not. In recent high-quality RCTs, however, the two modalities did not significantly differ. The evidence on surfactant effectiveness and its method of administration is sparse and inconsistent.
系统评价和随机对照试验在新生儿胎粪吸入综合征中肺表面活性物质治疗的系统综述。我们检索了 EMBASE、PROQUEST 和 PubMed，以总结不同的肺表面活性物质灌洗和肺表面活性物质冲击疗法对胎粪吸入综合征新生儿的影响。共有 1377 例患者，纳入了 3 项系统评价和 2 项 RCT 进行分析。低质量的系统评价得出肺表面活性物质有效的结论，存在高偏倚风险，而高质量的系统评价则得出肺表面活性物质无效的结论，存在低偏倚风险。在系统评价中，肺表面活性物质灌洗降低了死亡率、需要体外膜肺氧合和住院时间，而肺表面活性物质冲击疗法则没有。然而，在最近的高质量 RCT 中，两种方法在效果上没有显著差异。肺表面活性物质治疗的有效性及其给药方法的证据仍然很少且不一致。
