Prophylactic methylxanthines for endotracheal extubation in preterm infants

David J Henderson‐Smart; Peter G Davis

doi:10.1002/14651858.CD000139.pub2

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Analysis 1.1

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 1 Failed extubation.

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Analysis 1.2

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 2 Side effects.

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Analysis 1.3

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 3 PDA ligation.

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Analysis 1.4

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 4 PMA at last oxygen therapy.

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Analysis 1.5

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 5 PMA at last Endotracheal Tube.

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Analysis 1.6

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 6 PMA at last Positive Pressure Ventilation.

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Analysis 1.7

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 7 Bronchopulmonary dysplasia at term age.

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Analysis 1.8

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 8 Cognitive delay.

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Analysis 1.9

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 9 Cerebral Palsy.

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Analysis 1.10

Comparison 1 Methylxanthine vs control ‐ all preterm infants, Outcome 10 Death or major disability by 18‐21 months.

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Analysis 2.1

Comparison 2 Methylxanthine vs control ‐ infants <1 kg, Outcome 1 Failed extubation.

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Analysis 2.2

Comparison 2 Methylxanthine vs control ‐ infants <1 kg, Outcome 2 Neurodevelopmental abnormality at 30 months.

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Analysis 3.1

Comparison 3 Methylxanthine vs control ‐ infants >1 kg who failed first extubation, Outcome 1 Failed extubation.

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Comparison 1. Methylxanthine vs control ‐ all preterm infants

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Failed extubation Show forest plot	6	197	Risk Ratio (M‐H, Fixed, 95% CI)	0.48 [0.32, 0.71]

1.1 NCPAP use routine	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	0.39 [0.19, 0.81]
1.2 NCPAP use not routine	5	172	Risk Ratio (M‐H, Fixed, 95% CI)	0.51 [0.32, 0.80]
2 Side effects Show forest plot	2	56	Risk Ratio (M‐H, Fixed, 95% CI)	5.53 [0.28, 107.96]

3 PDA ligation Show forest plot	1	717	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.20, 0.52]

4 PMA at last oxygen therapy Show forest plot	1	666	Mean Difference (IV, Fixed, 95% CI)	‐1.5 [‐2.25, ‐0.75]

5 PMA at last Endotracheal Tube Show forest plot	1	668	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.42, ‐0.38]

6 PMA at last Positive Pressure Ventilation Show forest plot	1	667	Mean Difference (IV, Fixed, 95% CI)	‐1.10 [‐1.64, ‐0.56]

7 Bronchopulmonary dysplasia at term age Show forest plot	1	672	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.70, 0.93]

8 Cognitive delay Show forest plot	1	612	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.68, 1.01]

9 Cerebral Palsy Show forest plot	1	644	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.32, 0.92]

10 Death or major disability by 18‐21 months Show forest plot	1	676	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.73, 0.99]

Comparison 1. Methylxanthine vs control ‐ all preterm infants

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Comparison 2. Methylxanthine vs control ‐ infants <1 kg

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Failed extubation Show forest plot	2	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.58 [0.29, 1.16]

1.1 Age less than one week	2	41	Risk Ratio (M‐H, Fixed, 95% CI)	0.51 [0.25, 1.07]
1.2 Age more than one week	1	9	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.18, 22.06]
2 Neurodevelopmental abnormality at 30 months Show forest plot	1	32	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.13, 1.37]

Comparison 2. Methylxanthine vs control ‐ infants <1 kg

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Comparison 3. Methylxanthine vs control ‐ infants >1 kg who failed first extubation

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Failed extubation Show forest plot	1	10	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.01, 4.72]

Comparison 3. Methylxanthine vs control ‐ infants >1 kg who failed first extubation

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