Statistics from Altmetric.com
Less Invasive Surfactant Administration (LISA) has always had intuitive appeal, and many clinicians have quietly adopted this technique while the evidence has been accumulating. Then again, intubation-surfactant-extubation (InSurE) is also appealing, and it too has become a popular practice. Both have clear advantages over leaving a baby intubated. So which approach is better, or is there no real difference? Aldana-Aguirre et al have now performed a systematic review and meta-analysis of 6 randomised trials to give a firm answer: LISA is definitely better. How much better? Significantly less ventilation and bronchopulmonary dysplasia, though unsurprisingly no impact on mortality. The number needed to treat to prevent a case of BPD from these pooled data is 20. But look at the forest plots: the secondary message here is that so many of the relevant studies were underpowered, and the answer only emerges when meta-analysis is done. See page F17
Oxygen resuscitation for the most preterm: high or low?
Another meta-analysis here, from Oei et al. This time the secondary message, which I will tell you first, is that the paper is a lesson in how important masking can be. The subjects were all babies under 28 …
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.