Table 3

Outcomes by system

Non-ETS (n)ETS (n)RR (95% CI)
YesNoYesNo
Outcomes of respiratory system
Meconium aspiration syndrome
 Chettri et al, 201531 194220410.95 (0.57 to 1.59)
 Nangia et al, 201632 236528590.81 (0.51 to 1.29)
 Kumar et al, 201933 155121450.71 (0.40 to 1.26)
 Singh et al, 201934 443331441.38 (0.99 to 1.93)
Subtotal (I2=48.5%, p=0.12) 0.98 (0.71 to 1.35)
 Total events/total infants (%)101/292 (35)100/289 (35)201/581 (35)
Pneumothorax
 Chettri et al 201531 1601601.00 (0.06 to 15.63)
 Nangia et al 201632 2862850.99 (0.14 to 6.86)
 Singh et al 201934 2753720.65 (0.11 to 3.78)
Subtotal (I2=0.0%, p=0.94) 0.82 (0.25 to 2.66)
 Total events/total infants (%)5/226 (2)6/223 (3)11/449 (2)
Persistent pulmonary hypertension of the newborn
 Chettri et al 201531 2594570.50 (0.10 to 2.63)
 Kumar et al 201933 2644620.50 (0.09 to 2.64)
 Singh et al 201934 7706691.14 (0.40 to 3.22)
Subtotal (I2=0.0%, p=0.59) 0.79 (0.36 to 1.73)
 Total events/total infants (%)11/204 (5)14/202 (7)25/406 (6)
Secondary pneumonia
 Chettri et al 201531 8536551.33 (0.49 to 3.61)
 Singh et al 201934 195817581.09 (0.61 to 1.93)
Subtotal (I2=0.0%, p=0.73) 1.14 (0.70 to 1.88)
 Total events/total infants (%)27/138 (20)23/136 (17)50/274 (18)
Need for respiratory support, including mechanical ventilation
 Nangia et al, 201632 157317700.87 (0.47 to 1.63)
 Kumar et al, 201933 471948180.98 (0.79 to 1.21)
 Singh et al, 201934 69865101.03 (0.92 to 1.16)
Subtotal (I2=0.0%, p=0.73) 1.02 (0.92 to 1.13)
 Total events/total infants (%)131/231 (57)130/228 (57)261/459 (57)
Need for mechanical ventilation
 Chettri et al, 201531 154614471.07 (0.57 to 2.02)
 Nangia et al, 201632 88011760.72 (0.30 to 1.70)
 Kumar et al, 201933 8589570.89 (0.37 to 2.16)
 Singh et al, 201934 136411641.15 (0.55 to 2.41)
Subtotal (I2=0.0%, p=0.85) 0.98 (0.67 to 1.43)
 Total events/total infants (%)44/292 (15)45/289 (16)89/581 (15)
Outcomes of cardiovascular system, neurological system, neonatal mortality and infection
Outcomes of cardiovascular system
Shock
 Chettri et al, 201531 154612491.25 (0.64 to 2.45)
 Kumar et al, 201933 4629570.44 (0.14 to 1.37)
Subtotal (I2=58.7%, p=0.12) 0.83 (0.30 to 2.24)
 Total events/total infants (%)19/127 (15)21/127 (17)40/254 (16)
Outcomes of nervous system
Perinatal asphyxia/hypoxic-ischaemic encephalopathy
 Chettri et al, 201531 174419420.89 (0.52 to 1.55)
 Nangia et al, 201632 276128590.95 (0.62 to 1.48)
 Kumar et al, 201933 10568581.25 (0.53 to 2.97)
 Singh et al, 201934 304720551.46 (0.91 to 2.33)
Subtotal (I2=0.0%, p=0.48) 1.10 (0.85 to 1.43)
 Total events/total infants (%)84/292 (29)75/289 (26)159/581 (27)
Convulsions
 Chettri et al, 201531 233823381.00 (0.63 to 1.58)
 Kumar et al, 201933 5616600.83 (0.27 to 2.60)
Subtotal (I2=0.0%, p=0.77) 0.98 (0.64 to 1.49)
 Total events/total infants (%)28/127 (22)29/127 (23)57/254 (22)
Neonatal mortality
 Chettri et al, 201531 (in 7 days)8537541.14 (0.44 to 2.96)
 Nangia et al, 201632 4849780.44 (0.14 to 1.37)
 Kumar et al, 201933 5619570.56 (0.20 to 1.57)
 Singh et al, 201934 7704711.70 (0.52 to 5.58)
Subtotal (I2=17.1%, p=0.31) 0.83 (0.46,1.49)
 Total events/total infants (%)24/292 (8)29/289 (10)53/581(9)
Outcomes of infection
Blood culture-positive sepsis
 Chettri et al, 201531
5563581.67 (0.42 to 6.67)
 Kumar et al, 201933 0662640.20 (0.01 to 4.09)
 Singh et al, 201934 1763720.32 (0.03 to 3.05)
Subtotal (I2=21.2%, p=0.28) 0.74 (0.20 to 2.76)
 Total events/total infants (%)6/204 (3)8/202 (4)14/406 (3)
Outcomes regarding the need for initial resuscitation
Positive pressure ventilation
 Chettri et al, 201531 5565381.04 (0.91 to 1.18)
 Nangia et al, 201632 79968191.15 (1.01 to 1.31)
 Kumar et al, 201933 372941250.90 (0.68 to 1.20)
 Singh et al, 201934 562153221.03 (0.84 to 1.26)
Subtotal (I2=1.1%, p=0.39) 1.06 (0.98 to 1.15)
 Total events/total infants (%)227/292 (78)215/289 (74)442/581 (76)
Positive pressure ventilation via ET tube
 Chettri et al, 201531 273431300.87 (0.60 to 1.27)
 Nangia et al, 201632 147416710.87 (0.45 to 1.66)
 Kumar et al, 201933 254131350.81 (0.54 to 1.20)
 Singh et al, 201934 235420551.12 (0.67 to 1.86)
Subtotal (I2=0.0%, p=0.79) 0.89 (0.71 to 1.12)
 Total events/total infants (%)89/292 (30)98/289 (34)187/581 (32)
Chest compression
 Chettri et al, 201531 1603580.33 (0.04 to 3.12)
 Nangia et al, 201632 2861861.98 (0.18 to 21.41)
 Kumar et al, 201933 5613631.67 (0.42 to 6.69)
 Singh et al, 201934 4734710.97 (0.25 to 3.75)
Subtotal (I2=0.0%, p=0.64) 1.11 (0.48 to 2.55)
 Total events/total infants (%)12/292 (4)11/289 (4)23/581 (4)
Epinephrine
 Chettri et al, 201531 1603580.33 (0.04 to 3.12)
 Nangia et al, 201632 1871860.99 (0.06 to 15.56)
 Kumar et al, 201933 2641652.0 (0.19 to 21.53)
 Singh et al, 201934 1761740.97 (0.06 to 15.29)
Subtotal (I2=0.0%, p=0.75) 0.85 (0.24 to 2.97)
 Total events/total infants (%)5/292 (2)6/289 (2)11/581 (2)
Duration of mechanical ventilation and hospital stay*
Duration of mechanical ventilation (h) Mean difference (95% CI)
 Nangia et al, 201632 31.5±10.5030±10.001.50 (–1.54 to 4.54)
 Kumar et al, 201933 24±40.7434±34.07–10.00 (–22.81 to 2.81)
 Singh et al, 201934 83.04±15.8478.48±26.404.56 (–2.38 to 11.50)
Subtotal (I2=47.9%, p=0.15) 0.90 (–4.37 to 6.17)
Duration of hospital stay (d) Mean difference (95% CI)
 Nangia et al, 201632 2.95±0.862.99±1.26–0.04 (–0.36 to 0.28)
 Kumar et al, 201933 1.83±2.352.25±3.40–0.42 (–1.42 to 0.58)
 Singh et al, 201934 11.17±3.739.91±3.061.26 (0.18 to 2.34)
Subtotal (I2=66.2%, p=0.05) 0.19 (–0.59 to 0.97)
  • RR >1 indicated that the risk of acquiring illness or disease was greater in the non-ETS group and RR <1 indicated that the risk of acquiring illness or disease was lower in the non-ETS group

  • *The data were converted from median and range or IQR to mean and SD.

  • CI, confidence interval; ETS, endotracheal suctioning; RR, relative risk.