Meta AnalysisID 939

肾上腺素的给药时机、途径和剂量

CRD42019132219

Among neonates (of any gestation) ≤ 28 days of age who have no detected cardiac output or who have asystole or heart rate < 60 bpm despite ventilation and chest compressions, does any non-standard dose, interval or ro

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Record Fields

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Meta Analysis Id
939
Evidence Id
9497
Core Evidence Id
9497
Source Meta Analysis Id
912
Herb2 Meta Analysis Id
HBMA000912
Crd Id
CRD42019132219
Title
Timing, route and dose of epinephrine (adrenaline)
Review Question
Among neonates (of any gestation) ≤ 28 days of age who have no detected cardiac output or who have asystole or heart rate < 60 bpm despite ventilation and chest compressions, does any non-standard dose, interval or route (e.g. IO or ETT etc.) of epinephrine (adrenaline), compared to standard dose intravenous epinephrine (adrenaline) (0.01-0.03 mg/kg) at intervals of every 3-5 minutes, improve the primary outcome (survival at discharge) as well as any secondary outcomes?
Study Type Included
Included: • Randomized controlled trials (RCTs) • Non-randomized studies: non-randomized controlled trials, interrupted time series, controlled before-and-after studies, and cohort studies are eligible for inclusion. • All languages as long as there is an English abstract Excluded: • Unpublished studies (e.g., conference abstracts, trial protocols)* • Case series that cannot provide the estimate of incidence of outcomes • Animal studies
Condition Being Studied
Neonates (≤ 28 days) Standard dose epinephrine is 0.01-0.03 mg/kg per dose via intravenous route. Cardiac arrest or severe bradycardia (< 60 bpm)
Participant
Inclusion criteria: Neonates (of any gestation) within 28 days of age who have no detected cardiac output or who have asystole or heart rate < 60 bpm despite ventilation and chest compressions Exclusion criteria: Neonates who do not receive active resuscitation (palliative care only), Stillbirths
Animal
Human Disease Modelled
Intervention
Epinephrine (adrenaline) at any non-standard dose or intervals, or via any non-standard routes (e.g. IO or ETT etc.)
Comparator Control
Epinephrine (adrenaline) at standard dose (0.01-0.03 mg/kg) at intervals of every 3-5 minutes via intravenous route
Main Outcome
Mortality as defined by study authors Measures of effect Mortality as defined by study authors
Outcome Measure
Additional Outcome
Return of spontaneous circulation (ROSC*) “incidence and time until” HIE Stage moderate-severe (term only) IVH Grades III-IV (preterm only) Other morbidities in early infancy (e.g., necrotizing enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia, periventricular leukomalacia) Neurodevelopmental outcomes Measures of effect *ROSC is defined as the restoration of a spontaneous perfusing rhythm that results in more than an occasional gasp, fleeting palpated pulse, or arterial waveform.
Study Method
Meta-analysis, Systematic review
Keyword
Epinephrine; Humans
Contact
Tetsuya Isayama [email protected]
Organisational Affiliation
International Liaison Committee on Resuscitation http://www.ilcor.org
Funding Source
This Systematic Review was funded by the American Heart Association, on behalf of The International Liaison Committee on Resuscitation (ILCOR) for manuscript submission to the editor. The following investigators/institutions received payment from this funding source to complete this systematic review: Tetsuya Isayama as Expert Systematic Reviewer St. Michael’s Hospital Health Sciences Library; our information specialist, Carolyn Ziegler, did not receive compensation.
Other Selection Criteria
Final Publication
Isayama T, Mildenhall L, Schmölzer GM, Kim HS, Rabi Y, Ziegler C, Liley HG; INTERNATIONAL LIAISON COMMITTEE ON RESUSCITATION NEWBORN LIFE SUPPORT TASK FORCE. The Route, Dose, and Interval of Epinephrine for Neonatal Resuscitation: A Systematic Review. Pediatrics. 2020 Oct;146(4):e20200586. doi: 10.1542/peds.2020-0586. Epub 2020 Sep 9. PMID: 32907923.
Same Topic Review
Published Protocol
Review Type
Language
English
Country
Australia, Canada, Japan, New Zealand, South Korea
Review Stage
Review Completed published
First Submission Date
2019-06-16
Registration Date
2019-08-22
Anticipated Start Date
2019-02-19
Anticipated Completion Date
2019-09-08
Title Cn
肾上腺素的给药时机、途径和剂量
Title En
Timing, route and dose of epinephrine (adrenaline)
Bilingual Status
complete