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  • Review Article
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Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis

Journal of Perinatology volume 39, pages 173–183 (2019)Cite this article

Subjects

Abstract

Objective

To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE.

Study design

A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed

Results

Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38–0.85) and short-term oxygen requirements (MD −8.00, 95%CI −11.09 to −4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.43, 95%CI 0.31–0.61), but increased short-term oxygen requirements (MD 3.10, 95%CI 0.51–5.69) compared to INSURE approach.

Conclusions

In preterm infants with RDS, surfactant administration via SAD reduces the need for intubation/mechanical ventilation. Overall, available literature includes few, small, poor-quality studies. Surfactant administration via SAD should be limited to clinical trials.

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Acknowledgements

We thank Dr. Stubbs Brendon, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK for helping in literature search. We are grateful to the authors of 5 included trials for providing additional study information for this systematic review.

Author contributions

MGC analyzed the data, contributed to interpret the results and draft the manuscript, and approved the final manuscript as submitted. NV conceived and designed the study, contributed to the data analysis, and approved the final manuscript as submitted. FC contributed to interpret the results and draft the manuscript, and approved the final manuscript as submitted. PC and MM conducted the literature search, extracted key data from the included articles, critically revised the manuscript, and approved the final manuscript as submitted. DT conceived and designed the study, drafted the manuscript, and approved the final manuscript as submitted. All the Authors are responsible for the accuracy and the integrity of the data.

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Authors and Affiliations

  1. Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini, Genoa, Italy

    Maria Grazia Calevo

  2. National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy

    Nicola Veronese

  3. Independent statistician, Solagna, Italy

    Francesco Cavallin

  4. Pediatric Department, Ospedale dell’Angelo, Mestre, Venice, Italy

    Cavicchioli Paola

  5. Department of Anesthesia and Intensive Care, Careggi University Hospital, Florence, Italy

    Massimo Micaglio

  6. Department of Woman’s and Child’s Health, University of Padova, Padova, Italy

    Daniele Trevisanuto

Authors
  1. Maria Grazia Calevo
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  2. Nicola Veronese
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  3. Francesco Cavallin
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  4. Cavicchioli Paola
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  5. Massimo Micaglio
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  6. Daniele Trevisanuto
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Corresponding author

Correspondence to Daniele Trevisanuto.

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The authors declare that they have no conflict of interest.

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Calevo, M.G., Veronese, N., Cavallin, F. et al. Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis. J Perinatol 39, 173–183 (2019). https://doi.org/10.1038/s41372-018-0281-x

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