A meta-analysis of the effects and safety of pulmonary surfactants : combined with budesonide in bronchopulmonary dysplasia

Abstract EN

Context: The purpose of this analysis was to explore the effects and safety of Pulmonary Surfactants (PS) combined with budesonide in Bronchopulmonary Dysplasia (BPD) by a meta-analysis of Randomized Controlled Trials (RCTs).

Evidence acquisition: Literature searches were performed in PubMed, the Cochrane Library, EMBASE, the China Knowledge Net- work, and the Wanfang database to collect data from RCTs.

The primary outcomes were BPD incidence and BPD-related mortal- ity, while the secondary outcomes were BPD-related complications.

Bias was evaluated by the Cochrane risk assessment tool.

The RevMan 5.3 software was used for the meta-analysis, and the Egger’s test was used for publication bias assessment.

Results: A total of 720 subjects were enrolled from six RCTs, including 352 in the experimental group and 368 in the observation group.

The BPD incidence (RR = 0.

42, 95% CI [0.

37, 0.

89], P < 0.001) and BPD-related mortality (RR = 0.54, 95% CI [0.38, 0.89], P < 0.05) differed significantly between the two groups.

Significant differences were also found in intraventricular hemorrhage, infection/sepsis, Retinopathy of Prematurity (ROP), and Patent Ductus Arteriosus (PDA).

There were no significant differences in the incidence of PDA, Neonatal Necrotizing Enterocolitis (NEC), hyperglycemia, and hypertension.

Conclusions: The intratracheal instillation of pulmonary surfactants with budesonide can reduce the incidence of BPD and BPD- related mortality with no increased risk of short-term complications.