Meta AnalysisID 2819

静脉注射吲哚美辛、静脉注射布洛芬、口服布洛芬、口服对乙酰氨基酚与安慰剂治疗早产儿症状性动脉导管未闭的系统评价和网状Meta分析

CRD42015015797

Systematic review and network meta-analysis comparing indomethacin, ibuprofen, acetaminophen with placebo for treatment of Patent Ductus Arteriosus in preterm infants.

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Record Fields

Scalar fields from the final meta_analysis record.

Meta Analysis Id
2819
Evidence Id
11377
Core Evidence Id
11377
Source Meta Analysis Id
2763
Herb2 Meta Analysis Id
HBMA002763
Crd Id
CRD42015015797
Title
Systematic review and network meta-analysis of IV indomethacin versus IV Ibuprofen versus oral Ibuprofen versus oral acetaminophen versus placebo for treatment of symptomatic patent ductus arteriosus in preterm infants
Review Question
Systematic review and network meta-analysis comparing indomethacin, ibuprofen, acetaminophen with placebo for treatment of Patent Ductus Arteriosus in preterm infants.
Study Type Included
Randomized controlled trials
Condition Being Studied
Management of patent ductus arteriosus (PDA) in preterm infants is one of the most controversial topics in neonatal medicine. It is associated with a number of co-morbidities like necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and intraventricular hemorrhage (IVH). The management dilemmas have mainly centered on when to treat and with what to treat. To increase the complexity of matters, these two aspects of PDA management are not mutually exclusive, with the modality of treatment often being dictated by the timing of treatment. There have been a large number of published studies, meta-analyses, reviews, and editorials focusing on different aspects of management dilemmas. Regarding the timing of treatment, prophylactic therapy has gradually fallen out of favor and neonatal units have shifted towards a more conservative approach by treating only the clinically and echocardiographically significant PDAs. However, the big dilemma that still persists among neonatologists is what to use as the primary modality of treatment.
Participant
Preterm infants with hemodynamically significant PDA
Animal
Human Disease Modelled
Intervention
1. Intravenous Indomethacin or 2. Intravenous Ibuprofen or 3. Oral Ibuprofen or 4. Oral Acetaminophen or 5. IV acetaminophen Inclusion criteria: trials included in our review will have 1) Indomethacin or Ibuprofen or Acetaminophen being used for the treatment of clinically and/or echocardiographically determined hemodynamically significant PDA ; 2) have randomized infants to two intervention arms using the above mentioned drugs or an intervention arm using one of the above mentioned drugs and a control arm. Exclusion criteria: use of any intervention for prophylaxis
Comparator Control
Any of the interventions or placebo
Main Outcome
Closure of PDA
Outcome Measure
Additional Outcome
Incidence of necrotizing enterocolitis Incidence of oliguria Duration of ventilatory support
Study Method
Keyword
Acetaminophen; Cyclooxygenase Inhibitors; Ductus Arteriosus, Patent; Humans; Ibuprofen; Indomethacin; Infant, Newborn; Infant, Premature
Contact
Dr Mitra [email protected]
Organisational Affiliation
McMaster University
Funding Source
Other Selection Criteria
Final Publication
Mitra S, Florez ID, Tamayo ME, Mbuagbaw L, Vanniyasingam T, Veroniki AA, Zea AM, Zhang Y, Sadeghirad B, Thabane L. Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis. JAMA. 2018 Mar 27;319(12):1221-1238. doi: 10.1001/jama.2018.1896. Review. PubMed PMID: 29584842; PubMed Central PMCID: PMC5885871. https://www.ncbi.nlm.nih.gov/PubMed/29584842
Same Topic Review
Published Protocol
Review Type
Language
English
Country
England, Canada, Colombia
Review Stage
Review Completed published
First Submission Date
2018-08-02
Registration Date
2015-06-30
Anticipated Start Date
2015-07-01
Anticipated Completion Date
2016-04-01
Title Cn
静脉注射吲哚美辛、静脉注射布洛芬、口服布洛芬、口服对乙酰氨基酚与安慰剂治疗早产儿症状性动脉导管未闭的系统评价和网状Meta分析
Title En
Systematic review and network meta-analysis of IV indomethacin versus IV Ibuprofen versus oral Ibuprofen versus oral acetaminophen versus placebo for treatment of symptomatic patent ductus arteriosus in preterm infants
Bilingual Status
complete