Abstract
BackgroundInhaled steroids have been studied for both prevention and treatment of bronchopulmonary dysplasia (BPD). Results have been inconsistent. Recently, a large randomized controlled trial (RCT) has been reported.Methods/designWe will perform a comprehensive systematic literature search for randomized and quasi-randomized controlled trials that studied the efficacy and safety of inhaled corticosteroids administered to preterm infants (22–36 weeks) for either the prevention or treatment of BPD diagnosed by both clinical and physiological outcome criteria. We will assess potential risk of bias for each RCT meeting our selection criteria using the Cochrane risk of bias tool for RCTs. The primary outcome of interest will be mortality or BPD or both at 28 days postnatal age or 36 weeks postmenstrual age. Pooled estimates will be calculated using RevMan software with a random effects model as primary analysis. We will assess the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.DiscussionMeta-analytic estimates of eligible RCTs, potentially including a new large RCT, may significantly influence neonatal practice in the prevention and treatment of respiratory problems in preterm infants.Systematic review registrationPROSPEROCRD42015019628
Highlights
DiscussionMeta-analytic estimates of eligible randomized controlled trial (RCT), potentially including a new large randomized controlled trials (RCTs), may significantly influence neonatal practice in the prevention and treatment of respiratory problems in preterm infants
Inhaled steroids have been studied for both prevention and treatment of bronchopulmonary dysplasia (BPD)
Systemic use of corticosteroids is associated with significant adverse effects on growth and neurodevelopmental outcome with increased
Summary
Many treatments have been tried and tested for the prevention or treatment of BPD. Clinicians anxiously await convincing evidence of any new intervention that may answer this urgent need. Previous systematic reviews and meta-analyses of inhaled corticosteroids for preterm infants have focused on specific indications and timing, advancing understanding of the pathophysiology of BPD may suggest, for example, the distinction between prevention and treatment to be rather artificial. This proposed review, by employing more inclusive inclusion criteria and adding new studies, aims to offer information that may be useful to the practicing neonatologist
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