Synchronized mechanical ventilation for respiratory support in newborn infants

Anne Greenough; Thomas E Rossor; Adesh Sundaresan; Vadivelam Murthy; Anthony D Milner

doi:10.1002/14651858.CD000456.pub5

Scolaris Content Display Scolaris Content Display

Topics

Figure 1

Study flow diagram: review update

Navigate to figure in ReviewOpen in new tab

Analysis 1.1

Comparison 1: HFPPV vs CMV, Outcome 1: Death

Navigate to figure in ReviewOpen in new tab

Analysis 1.2

Comparison 1: HFPPV vs CMV, Outcome 2: Air leaks

Navigate to figure in ReviewOpen in new tab

Analysis 1.3

Comparison 1: HFPPV vs CMV, Outcome 3: Total air leak

Navigate to figure in ReviewOpen in new tab

Analysis 1.4

Comparison 1: HFPPV vs CMV, Outcome 4: BPD (oxygen dependency at 28 days)

Navigate to figure in ReviewOpen in new tab

Analysis 1.5

Comparison 1: HFPPV vs CMV, Outcome 5: IVH

Navigate to figure in ReviewOpen in new tab

Analysis 2.1

Comparison 2: ACV/SIMV vs CMV, Outcome 1: Death

Navigate to figure in ReviewOpen in new tab

Analysis 2.2

Comparison 2: ACV/SIMV vs CMV, Outcome 2: Air leaks

Navigate to figure in ReviewOpen in new tab

Analysis 2.3

Comparison 2: ACV/SIMV vs CMV, Outcome 3: Duration of ventilation (hours)

Navigate to figure in ReviewOpen in new tab

Analysis 2.4

Comparison 2: ACV/SIMV vs CMV, Outcome 4: Extubation failure

Navigate to figure in ReviewOpen in new tab

Analysis 2.5

Comparison 2: ACV/SIMV vs CMV, Outcome 5: Severe IVH

Navigate to figure in ReviewOpen in new tab

Analysis 2.6

Comparison 2: ACV/SIMV vs CMV, Outcome 6: BPD (oxygen dependency at 28 days)

Navigate to figure in ReviewOpen in new tab

Analysis 2.7

Comparison 2: ACV/SIMV vs CMV, Outcome 7: Moderate/Severe BPD (oxygen dependent at 36 weeks PCA)

Navigate to figure in ReviewOpen in new tab

Analysis 3.1

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 1: Death

Navigate to figure in ReviewOpen in new tab

Analysis 3.2

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 2: BPD: oxygen requirement at 28 days

Navigate to figure in ReviewOpen in new tab

Analysis 3.3

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 3: Moderate/ Severe BPD: Oxygen requirement at 36 weeks PCA

Navigate to figure in ReviewOpen in new tab

Analysis 3.4

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 4: Death or BPD

Navigate to figure in ReviewOpen in new tab

Analysis 3.5

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 5: Duration of mechanical ventilation

Navigate to figure in ReviewOpen in new tab

Analysis 3.6

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 6: Air leaks

Navigate to figure in ReviewOpen in new tab

Analysis 3.7

Comparison 3: SIMV or SIMV + PS vs HFOV, Outcome 7: IVH Grade 3/4

Navigate to figure in ReviewOpen in new tab

Analysis 4.1

Comparison 4: ACV vs SIMV, Outcome 1: Duration of weaning (hours)

Navigate to figure in ReviewOpen in new tab

Analysis 4.2

Comparison 4: ACV vs SIMV, Outcome 2: Weaning failure

Navigate to figure in ReviewOpen in new tab

Analysis 4.3

Comparison 4: ACV vs SIMV, Outcome 3: Extubation failure

Navigate to figure in ReviewOpen in new tab

Analysis 4.4

Comparison 4: ACV vs SIMV, Outcome 4: Air leaks

Navigate to figure in ReviewOpen in new tab

Analysis 5.1

Comparison 5: PS + SIMV versus SIMV, Outcome 1: Death

Navigate to figure in ReviewOpen in new tab

Analysis 5.2

Comparison 5: PS + SIMV versus SIMV, Outcome 2: Air leaks

Navigate to figure in ReviewOpen in new tab

Analysis 5.3

Comparison 5: PS + SIMV versus SIMV, Outcome 3: BPD

Navigate to figure in ReviewOpen in new tab

Analysis 5.4

Comparison 5: PS + SIMV versus SIMV, Outcome 4: Severe IVH (grade III and IV)

Navigate to figure in ReviewOpen in new tab

Analysis 6.1

Comparison 6: PRVCV vs SIMV, Outcome 1: Death prior to discharge

Navigate to figure in ReviewOpen in new tab

Analysis 6.2

Comparison 6: PRVCV vs SIMV, Outcome 2: BPD: oxygen requirement at 36 weeks in survivors

Navigate to figure in ReviewOpen in new tab

Analysis 6.3

Comparison 6: PRVCV vs SIMV, Outcome 3: Air leak

Navigate to figure in ReviewOpen in new tab

Analysis 6.4

Comparison 6: PRVCV vs SIMV, Outcome 4: Severe IVH

Navigate to figure in ReviewOpen in new tab

Analysis 7.1

Comparison 7: PSV vs SIMV, Outcome 1: Duration of weaning

Navigate to figure in ReviewOpen in new tab

Analysis 7.2

Comparison 7: PSV vs SIMV, Outcome 2: Extubation failure

Navigate to figure in ReviewOpen in new tab

Analysis 7.3

Comparison 7: PSV vs SIMV, Outcome 3: Air leaks (total)

Navigate to figure in ReviewOpen in new tab

Analysis 7.4

Comparison 7: PSV vs SIMV, Outcome 4: Moderate/Severe BPD: oxygen requirement at 36 weeks PCA

Navigate to figure in ReviewOpen in new tab

Study	Participants	Duration of weaning ACV (Median (range))	Duration of weaning PSV (Median(range))	Significance
Duration of weaning
Patel 2012	36	34 (7‐100)	27 (10‐169)	p=0.88

Analysis 8.1

Comparison 8: ACV versus PSV, Outcome 1: Duration of weaning

Navigate to figure in Review

Comparison 1. HFPPV vs CMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Death Show forest plot	4	647	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.61, 1.00]

1.2 Air leaks Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

1.2.1 Pneumothorax	3	585	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.51, 0.93]
1.2.2 Pulmonary interstitial emphysema	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.68 [0.49, 0.94]
1.3 Total air leak Show forest plot	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	0.25 [0.06, 1.08]

1.4 BPD (oxygen dependency at 28 days) Show forest plot	4	647	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.77, 1.46]

1.5 IVH Show forest plot	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	0.12 [0.02, 0.94]

Comparison 1. HFPPV vs CMV

Navigate to table in Review

Comparison 2. ACV/SIMV vs CMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
2.1 Death Show forest plot	6	1790	Risk Ratio (M‐H, Fixed, 95% CI)	1.17 [0.94, 1.47]

2.2 Air leaks Show forest plot	7	1830	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.76, 1.27]

2.3 Duration of ventilation (hours) Show forest plot	5	1463	Mean Difference (IV, Fixed, 95% CI)	‐38.30 [‐53.90, ‐22.69]

2.4 Extubation failure Show forest plot	4	1056	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.68, 1.28]

2.5 Severe IVH Show forest plot	6	1790	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.73, 1.40]

2.6 BPD (oxygen dependency at 28 days) Show forest plot	4	805	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.75, 1.12]

2.7 Moderate/Severe BPD (oxygen dependent at 36 weeks PCA) Show forest plot	2	1310	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.75, 1.08]

Comparison 2. ACV/SIMV vs CMV

Navigate to table in Review

Comparison 3. SIMV or SIMV + PS vs HFOV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
3.1 Death Show forest plot	4	996	Risk Ratio (M‐H, Fixed, 95% CI)	1.25 [0.91, 1.71]

3.2 BPD: oxygen requirement at 28 days Show forest plot	1	110	Risk Ratio (M‐H, Fixed, 95% CI)	3.21 [0.37, 27.83]

3.3 Moderate/ Severe BPD: Oxygen requirement at 36 weeks PCA Show forest plot	3	869	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [1.07, 1.65]

3.4 Death or BPD Show forest plot	1	356	Risk Ratio (M‐H, Fixed, 95% CI)	2.38 [1.41, 4.03]

3.5 Duration of mechanical ventilation Show forest plot	2	466	Mean Difference (IV, Fixed, 95% CI)	1.89 [1.04, 2.74]

3.6 Air leaks Show forest plot	3	1398	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.70, 1.19]

3.6.1 Pulmonary interstitial emphysema	1	498	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.44, 0.99]
3.6.2 Pneumothorax	3	900	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.82, 1.64]
3.7 IVH Grade 3/4 Show forest plot	4	1010	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.71, 1.24]

Comparison 3. SIMV or SIMV + PS vs HFOV

Navigate to table in Review

Comparison 4. ACV vs SIMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
4.1 Duration of weaning (hours) Show forest plot	3	120	Mean Difference (IV, Fixed, 95% CI)	‐42.38 [‐94.35, 9.60]

4.2 Weaning failure Show forest plot	3	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.31, 1.93]

4.3 Extubation failure Show forest plot	3	120	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.37, 2.67]

4.4 Air leaks Show forest plot	3	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.23, 2.83]

4.4.1 Total air leaks	3	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.23, 2.83]

Comparison 4. ACV vs SIMV

Navigate to table in Review

Comparison 5. PS + SIMV versus SIMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
5.1 Death Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.1.1 Death during first 28 days	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.08, 2.01]
5.1.2 Death prior to discharge	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.87 [0.31, 2.43]
5.2 Air leaks Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.2.1 Pneumothorax	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	Not estimable
5.2.2 Pulmonary interstitial emphysema	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.73 [0.25, 2.15]
5.3 BPD Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.3.1 BPD (oxygen dependency at 28 days)	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.84, 1.23]
5.3.2 Moderate/Severe BPD (oxygen dependency at 36 weeks PMA)	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.71 [0.42, 1.18]
5.4 Severe IVH (grade III and IV) Show forest plot	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.41, 2.08]

Comparison 5. PS + SIMV versus SIMV

Navigate to table in Review

Comparison 6. PRVCV vs SIMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
6.1 Death prior to discharge Show forest plot	1	211	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.50, 2.11]

6.2 BPD: oxygen requirement at 36 weeks in survivors Show forest plot	1	185	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.55, 1.27]

6.3 Air leak Show forest plot	1	424	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.51, 2.13]

6.3.1 PIE	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	1.66 [0.56, 4.91]
6.3.2 Pneumothorax	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.26, 1.88]
6.4 Severe IVH Show forest plot	1	203	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.29, 1.58]

Comparison 6. PRVCV vs SIMV

Navigate to table in Review

Comparison 7. PSV vs SIMV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
7.1 Duration of weaning Show forest plot	1	60	Mean Difference (IV, Fixed, 95% CI)	‐11.30 [‐26.53, 3.93]

7.2 Extubation failure Show forest plot	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.57, 2.07]

7.3 Air leaks (total) Show forest plot	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.20 [0.01, 4.00]

7.4 Moderate/Severe BPD: oxygen requirement at 36 weeks PCA Show forest plot	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.46, 2.17]

Comparison 7. PSV vs SIMV

Navigate to table in Review

Comparison 8. ACV versus PSV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
8.1 Duration of weaning Show forest plot	1		Other data	No numeric data

Comparison 8. ACV versus PSV

Navigate to table in Review

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Cochrane Review language

Website language

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet

Scolaris Content Display Scolaris Content Display

Topics

Scolaris Language Selector Scolaris Language Selector

Scolaris Content Display Scolaris Content Display

Previously accessed institutions

Scolaris Content Display Scolaris Content Display

Institutional users

Previously accessed institutions

Other access options

	Cochrane Review language Select your preferred language for Cochrane Reviews and other content. Sections without translation will be in English.

	Website language Select your preferred language for the Cochrane Library website.

Cochrane Review language

Website language

Related content

Related reviews and protocols

Cochrane Clinical Answers

Topics

Copy or download citation

Cochrane Review language

Website language

Previously accessed institutions

Institutional users

Previously accessed institutions

Other access options