Meta AnalysisID 1356

抗凝血酶预防极早产儿脑室内出血 [Cochrane协议]

CRD42015026195

To assess whether the prophylactic administration of antithrombin (started within the first 24 hours after birth) compared to placebo, no treatment, or heparin, reduces the incidence of germinal matrix-intraventricular h

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Record Fields

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Meta Analysis Id
1356
Evidence Id
9914
Core Evidence Id
9914
Source Meta Analysis Id
1315
Herb2 Meta Analysis Id
HBMA001315
Crd Id
CRD42015026195
Title
Antithrombin for the prevention of intraventricular hemorrhage in very preterm infants [Cochrane Protocol]
Review Question
To assess whether the prophylactic administration of antithrombin (started within the first 24 hours after birth) compared to placebo, no treatment, or heparin, reduces the incidence of germinal matrix-intraventricular hemorrhage in preterm neonates at risk of intraventricular hemorrhage. Subgroup analysis will address gestational age, birth weight, requirement for assisted ventilation, plasma-derived versus recombinant antithrombin (see Subgroup analysis and investigation of heterogeneity).
Study Type Included
We will include prospective randomized controlled clinical trials, quasi-randomized trials and cluster trials. We will exclude cross-over trials. Studies where antithrombin is administered to ensure appropriate anticoagulation (e.g., during extracorporeal membrane oxygenation) are beyond the scope of the present review.
Condition Being Studied
The Cochrane Neonatal Group
Participant
Infant newborns admitted to neonatal intensive care units, gestational age < 32 weeks, any birth weight. We will exclude trials where antithrombin, regardless of the dosage, is administered during extracorporeal membrane oxygenation.
Animal
Human Disease Modelled
Intervention
<ol> Antithrombin compared to placebo or no treatment (specific subgroup analyses for each comparison are described in Subgroup analysis and investigation of heterogeneity) Antithrombin compared to unfractionated heparin Antithrombin compared to low-molecular-weight heparin</ol> We will include any dose, mode of administration, and duration of antithrombin therapy in this review. As the aim of the review is to assess the ability of antithrombin to prevent germinal matrix-intraventricular hemorrhage, we will only include studies in which antithrombin administration was started within the first 24 hours of life.
Comparator Control
<ol> Antithrombin compared to placebo or no treatment (specific subgroup analyses for each comparison are described in Subgroup analysis and investigation of heterogeneity) Antithrombin compared to unfractionated heparin Antithrombin compared to low-molecular-weight heparin </ol>
Main Outcome
Intraventricular hemorrhage: Any severity, grade 1 to 4 according to Papile 1978 Severe intraventricular hemorrhage: grade 3 and 4 according to Papile 1978 </ul>
Outcome Measure
Additional Outcome
Mortality: neonatal mortality (&lt; 28 days of age); infant mortality (one year of age) Bronchopulmonary dysplasia/chronic lung disease 28 days (NIH 1979) 36 weeks postmenstrual age (Jobe 2001) physiological definition (Walsh 2004) </ul> Pneumothorax (on chest X-ray) Duration of mechanical ventilation (intermittent positive pressure ventilation; days) Duration of respiratory support ( intermittent positive pressure ventilation or continuous positive airway pressure; days) Duration of oxygen therapy (days) Duration of hospital stay (days) Retinopathy of prematurity (any; requiring laser therapy) Necrotizing enterocolitis (any grade; requiring surgery) Need for blood transfusions Need for medical or surgical treatment for persistent ductus arteriosus Pulmonary hemorrhage Clinically apparent bleeding during treatment during the first week of life Central catheter (umbilical line or peripherally inserted central catheter) occlusion Stroke during treatment (yes/no) Cerebellar hemorrhage at brain ultrasound in the first month of life Cystic periventricular leukomalacia at brain ultrasound in the first month of life Brain magnetic resonance imaging (MRI) abnormalities at term equivalent age Cerebral hemodynamics impairment, based on cerebral near-infrared spectroscopy in the first three days of life Major neurodevelopmental disability assessed at ≥12 months of age (defined as cerebral palsy, developmental delay (Bayley or Griffith assessment more than two standard deviations (SD) below the mean) or intellectual impairment (intelligence quotient (IQ) more than two SD below mean), blindness (vision &lt; 6/60 in both eyes) or sensorineural deafness requiring amplification </ul>
Study Method
Keyword
Antithrombin III; Antithrombins; Cerebral Hemorrhage; Humans; Infant, Newborn; Infant, Premature
Contact
Organisational Affiliation
Funding Source
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
Review Stage
First Submission Date
Registration Date
Anticipated Start Date
Anticipated Completion Date
Title Cn
抗凝血酶预防极早产儿脑室内出血 [Cochrane协议]
Title En
Antithrombin for the prevention of intraventricular hemorrhage in very preterm infants [Cochrane Protocol]
Bilingual Status
complete