预防性西地那非预防支气管肺发育不良:系统综述和荟萃分析。

IF 1 4区 医学 Q3 PEDIATRICS Pediatrics International Pub Date : 2024-01-01 DOI:10.1111/ped.15749
Katsuya Hirata, Atsuko Nakahari, Mami Takeoka, Masahiko Watanabe, Yutaka Nishimura, Yoshinori Katayama, Tetsuya Isayama
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引用次数: 0

摘要

背景:支气管肺发育不良(BPD)一直是导致极早产儿死亡和发病的主要因素之一。早期使用西地那非预防 BPD 的效果仍不确定。本研究旨在探讨在早产儿生命早期阶段预防性使用西地那非预防死亡率和BPD的有效性和安全性:方法:检索了MEDLINE、Embase、Cochrane对照试验中央登记册、护理与相关健康文献累积索引和Ichushi。纳入了已发表的随机对照试验 (RCT)、非 RCT、间断时间序列、队列研究、病例对照研究和前后对照研究。两名审稿人独立筛选了标题、摘要和全文,提取了数据,评估了偏倚风险,并按照建议分级评估和发展与评价方法评价了证据的确定性(CoE)。采用随机效应模型对研究性试验进行荟萃分析:本综述包括三项研究性试验(162 名婴儿)。预防性西地那非组和安慰剂组在死亡率方面无明显差异(风险比 [RR]:1.32;95% 置信区间 [CI]:0.16-10.75;极低 CoE)、BPD(RR:1.20;95% 置信区间 [CI]:0.79-1.83;极低 CoE)和所有其他评估结果(均为极低 CoE)。所有评估结果的样本量均小于最佳样本量,这表明有必要进一步开展试验:结论:在有BPD风险的人群中预防性使用西地那非并不会对死亡率、BPD和其他结果产生任何有利影响,也不会增加副作用。
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Prophylactic sildenafil to prevent bronchopulmonary dysplasia: A systematic review and meta-analysis.

Background: Bronchopulmonary dysplasia (BPD) persists as one of the foremost factors contributing to mortality and morbidity in extremely preterm infants. The effectiveness of administering sildenafil early on to prevent BPD remains uncertain. The aim of this study was to investigate the efficacy and safety of prophylactically administered sildenafil during the early life stages of preterm infants to prevent mortality and BPD.

Methods: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Ichushi were searched. Published randomized controlled trials (RCTs), non-RCTs, interrupted time series, cohort studies, case-control studies, and controlled before-and-after studies were included. Two reviewers independently screened the title, abstract, and full text, extracted data, assessed the risk of bias, and evaluated the certainty of evidence (CoE) following the Grading of Recommendations Assessment and Development and Evaluation approach. The random-effects model was used for a meta-analysis of RCTs.

Results: This review included three RCTs (162 infants). There were no significant differences between the prophylactic sildenafil and placebo groups in mortality (risk ratio [RR]: 1.32; 95% confidence interval [CI]: 0.16-10.75; very low CoE), BPD (RR: 1.20; 95% CI: 0.79-1.83; very low CoE), and all other outcome assessed (all with very low CoE). The sample sizes were less than the optimal sizes for all outcomes assessed, indicating the need for further trials.

Conclusions: The prophylactic use of sildenafil in individuals at risk of BPD did not indicate any advantageous effects in terms of mortality, BPD, and other outcomes, or increased side effects.

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来源期刊
Pediatrics International
Pediatrics International 医学-小儿科
CiteScore
2.00
自引率
7.10%
发文量
519
审稿时长
12 months
期刊介绍: Publishing articles of scientific excellence in pediatrics and child health delivery, Pediatrics International aims to encourage those involved in the research, practice and delivery of child health to share their experiences, ideas and achievements. Formerly Acta Paediatrica Japonica, the change in name in 1999 to Pediatrics International, reflects the Journal''s international status both in readership and contributions (approximately 45% of articles published are from non-Japanese authors). The Editors continue their strong commitment to the sharing of scientific information for the benefit of children everywhere. Pediatrics International opens the door to all authors throughout the world. Manuscripts are judged by two experts solely upon the basis of their contribution of original data, original ideas and their presentation.
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