Abstract

VILLASIS-KEEVER, Miguel Ángel et al. Systematic review and meta-analysis of bovine surfactant effectiveness for the treatment of respiratory distress syndrome in premature newborns. Bol. Med. Hosp. Infant. Mex. [online]. 2010, vol.67, n.6, pp.477-491. ISSN 1665-1146.

Background. In order to evaluate the effectiveness of the bovine surfactant (BS) for the treatment of newborns with respiratory distress syndrome (RDS), we performed a systematic review and meta-analysis. Methods. Randomized-controlled trials (RCT) assessing the BS in comparison with placebo for the treatment of prematures with RDS were included. Outcome measures evaluated were: mortality, morbidity, days on mechanical ventilation (MV) and length of hospitalization. RCT published until 2010 were obtained from Medline, EMBASE and Cochrane Collaboration. Selection of included studies was based on a peer-review process. For the meta-analyses, relative risk (RR) and weighted mean differences (WMD) were calculated, with 95% confidence intervals (95%CI). Results. From 865 titles and abstracts obtained, 89 papers were reviewed and 12 RCT were selected. Among the outcome measures assessed, BS was shown to be effective in only in four: mortality (RR 0.73, 95% CI 0.60-0.88, p =0.001), pneumothorax (RR 0.41; 95% CI 0.33-0.51, p <0.0001), pulmonary interstitial emphysema (RR 0.45; 95% CI 0.36-0.56, p <0.0001) and on days of MV (WMD -9.57; 95% CI -16.58 to -2.56, p =0.007). However, we did not find any positive effect on bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage or abnormal neurological development. Conclusions. In newborns with RDS, bovine surfactant is effective regarding mortality, pneumothorax, and pulmonary interstitial emphysema, as well as on decrease in the length of MV and possibly on length of hospitalization.

Keywords : respiratory distress syndrome; newborn; premature; bovine surfactant; meta-analysis.