[Efficacy of pulmonary surfactant therapy in neonates with meconium aspiration syndrome: a meta-analysis].
OBJECTIVE
The efficacy of pulmonary surfactant (PS) replacement therapy for meconium aspiration syndrome (MAS) remains controversial. This study aimed to evaluate the efficacy of PS therapy in neonates with MAS by a meta-analysis.


METHODS
Randomized controlled trials (RCTs) on the treatment of MAS with PS were searched electronically in medical debases including PubMed, Science Citation Index, The Cochrane Central Register of Controlled Trials, Ovid, EBSCOhost, BIOSIS previews, Chinese BioMedical Literature Database, Wanfang Database and VIP Chinese Sci-Tech Periodical Database. The Cochrane Handbook 5.0.2 was employed to evaluate methodological quality. RevMan 5.0.25 software was used for the meta-analysis.


RESULTS
Eight RCTs including 512 MAS neonates (257 cases in the PS treatment group and 255 cases in the control group) were enrolled in this meta-analysis. The meta-analysis showed that PS treatment reduced oxygenation index (MD=-2.59; 95%CI: -4.33, -0.86; P=0.003), increased arterial oxygen/alveolar oxygen ratio (MD=0.05; 95%CI: 0.05, 0.06; P<0.00001), shortened hospitalization days (MD=-4.94; 95%CI: -7.44, -2.44; P=0.0001) and decreased mortality rate (OR=0.47; 95%CI: 0.24, 0.93; P=0.03) significantly. There were no statistical differences in the durations of mechanical ventilation and oxygen therapy, and the incidences of air leak, pulmonary hemorrhage and intracranial hemorrhage between the PS treatment and control groups.


CONCLUSIONS
Currently published evidence from RCTs suggests that PS replacement therapy is effective for MAS, however because of the limited quantity and quality of trials enrolled in the study, further evidence from RCTs is needed to prove the efficacy.
Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
Fei-Fei
FF
Luo
Di-Yuan
DY
Yang
Pan
P
Chen
Zi-Yu
ZY
Hua
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D011663:Pulmonary Surfactants