title: Mechanical ventilation modes for respiratory distress syndrome in infants: a systematic review and network meta-analysis.
abstract: BACKGROUND
  The effects of different mechanical ventilation (MV) modes on mortality outcome in infants with respiratory distress syndrome (RDS) are not well known.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Web of Science for studies published through April 2014 that assessed mortality in infants with RDS given different MV modes. We assessed studies for eligibility, extracted data, and subsequently pooled the data. A Bayesian fixed-effects model was used to combine direct comparisons with indirect evidence. We also performed sensitivity analyses and rankings of the competing treatment modes.
  
  
  RESULTS
  In total, 20 randomized controlled trials were included for the network meta-analysis, which consisted of 2,832 patients who received one of 16 ventilation modes. Compared with synchronized intermittent mandatory ventilation (SIMV) + pressure support ventilation (PSV), time-cycled pressure-limited ventilation (TCPL) (hazard ratio (HR) 0.290; 95% confidence interval (CI) 0.071 to 0.972), high-frequency oscillatory ventilation (HFOV) (HR 0.294; 95% CI 0.080 to 0.852), SIMV + volume-guarantee (VG) (HR 0.122; 95% CI 0.014 to 0.858), and volume-controlled (V-C) (HR 0.139; 95% CI 0.024 to 0.677) ventilation modes are associated with lower mortality. The combined results of available ventilation modes were not significantly different in regard to the incidences of patent ductus arteriosus and intraventricular hemorrhage.
  
  
  CONCLUSIONS
  Compared with the SIMV + PSV ventilation mode, the TCPL, HFOV, SIMV + VG, and V-C ventilation modes are associated with lower mortality.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. changsongwang@aliyun.com.
authors.forename: Changsong
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. 780214870@qq.com.
authors.forename: Libo
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. ccjnzb0602@163.com.
authors.forename: Chunjie
authors.initials: C
authors.lastname: Chi
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. 851787303@qq.com.
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. 57077184@qq.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. 774523831@qq.com.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. 767721743@qq.com.
authors.forename: Nana
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Implantology, Hospital of Stomatology, Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. ellenchi@163.com.
authors.forename: Yibo
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The Third Affiliated Hospital of Harbin Medical University, No 150 Haping Str, Nangang District, Harbin, Heilongjiang, 150001, China. chichunjie0602@gmail.com.
authors.forename: Zhaodi
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Harbin Medical University, No 23 Youzheng Str, Nangang District, Harbin, Heilongjiang, 150001, China. enyouli@aliyun.com.
authors.forename: Enyou
authors.initials: E
authors.lastname: Li
mesh_terms: D001499:Bayes Theorem; D006801:Humans; D007231:Infant, Newborn; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*