Corticosteroids for treating hypotension in preterm infants

Hafis Ibrahim; Ian P Sinha; Nimish V Subhedar

doi:10.1002/14651858.CD003662.pub4

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

$Forest plot of comparison: 3 Steroid versus placebo or nothing (treatment of refractory hypotension), outcome: 3.11 Treatment failure.$

Figure 1

Forest plot of comparison: 3 Steroid versus placebo or nothing (treatment of refractory hypotension), outcome: 3.11 Treatment failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 1 Mortality to discharge.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 2 IVH grade 3 or 4.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 3 Periventricular leukomalacia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 4 Chronic lung disease in surviving infants (at 36 weeks post‐menstrual age).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 5 Necrotising enterocolitis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Steroid versus placebo for the primary treatment of hypotension, Outcome 6 Bacterial sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 1 IVH all grades.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 2 Mortality to discharge.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 3 Retinopathy of prematurity in surviving infants.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 4 Chronic lung disease in surviving infants (at 36 weeks post‐menstrual age).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 5 Necrotising enterocolitis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 6 Hyperglycaemia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 7 Any sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 8 Bacterial sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.9

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 9 Fungal sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.10

Comparison 2 Steroid versus other drug (primary treatment of hypotension), Outcome 10 Treatment failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 1 Mortality to discharge.$

Analysis 3.1

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 1 Mortality to discharge.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 2 IVH grade 3 or 4.$

Analysis 3.2

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 2 IVH grade 3 or 4.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 3 IVH all grades.$

Analysis 3.3

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 3 IVH all grades.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 4 Periventricular leukomalacia.$

Analysis 3.4

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 4 Periventricular leukomalacia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 5 Retinopathy of prematurity >Grade 2.$

Analysis 3.5

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 5 Retinopathy of prematurity >Grade 2.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 6 Chronic lung disease in surviving infants(36 weeks post menstrual age).$

Analysis 3.6

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 6 Chronic lung disease in surviving infants(36 weeks post menstrual age).

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 7 Necrotising enterocolitis.$

Analysis 3.7

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 7 Necrotising enterocolitis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 8 Gastric bleeding.$

Analysis 3.8

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 8 Gastric bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 9 Gastrointestinal perforation.$

Analysis 3.9

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 9 Gastrointestinal perforation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 10 Bacterial sepsis.$

Analysis 3.10

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 10 Bacterial sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 11 Treatment failure.$

Analysis 3.11

Comparison 3 Steroid versus placebo or nothing (treatment of refractory hypotension), Outcome 11 Treatment failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1. Steroid versus placebo for the primary treatment of hypotension

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality to discharge Show forest plot	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	0.14 [0.01, 2.42]

2 IVH grade 3 or 4 Show forest plot	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.40, 1.76]

3 Periventricular leukomalacia Show forest plot	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.22, 18.33]

4 Chronic lung disease in surviving infants (at 36 weeks post‐menstrual age) Show forest plot	1	15	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.26, 1.68]

5 Necrotising enterocolitis Show forest plot	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	0.14 [0.01, 2.42]

6 Bacterial sepsis Show forest plot	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.09, 1.23]

Comparison 1. Steroid versus placebo for the primary treatment of hypotension

Ir a la tabla de la revisión

Comparison 2. Steroid versus other drug (primary treatment of hypotension)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 IVH all grades Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	1.51 [0.42, 5.48]

2 Mortality to discharge Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	1.81 [0.18, 18.39]

3 Retinopathy of prematurity in surviving infants Show forest plot	1	37	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.33, 4.88]

4 Chronic lung disease in surviving infants (at 36 weeks post‐menstrual age) Show forest plot	1	37	Risk Ratio (M‐H, Fixed, 95% CI)	2.37 [0.52, 10.70]

5 Necrotising enterocolitis Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	3.62 [0.44, 29.60]

6 Hyperglycaemia Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	1.27 [0.48, 3.33]

7 Any sepsis Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	0.60 [0.20, 1.82]

8 Bacterial sepsis Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	0.60 [0.20, 1.82]

9 Fungal sepsis Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

10 Treatment failure Show forest plot	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	8.18 [0.47, 142.62]

Comparison 2. Steroid versus other drug (primary treatment of hypotension)

Ir a la tabla de la revisión

Comparison 3. Steroid versus placebo or nothing (treatment of refractory hypotension)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality to discharge Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	1.47 [0.53, 4.09]

1.1 Mortality to Discharge‐Dexamethasone versus placebo	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	1.69 [0.37, 7.67]
1.2 Mortality to Discharge‐Hydrocortisone versus placebo	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [0.33, 5.33]
2 IVH grade 3 or 4 Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.74 [0.26, 2.09]

2.1 IVH grade 3 or 4‐Dexamethasone versus placebo	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.20, 6.24]
2.2 IVH grade 3 or 4‐Hydrocortisone versus placebo	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.16, 2.23]
3 IVH all grades Show forest plot	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.41, 3.08]

4 Periventricular leukomalacia Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.25, 4.64]

4.1 Periventricular leukomalacia‐Dexamethasone versus placebo	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.20, 6.24]
4.2 Periventricular leukomalacia‐Hydrocortisone versus placebo	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 15.08]
5 Retinopathy of prematurity >Grade 2 Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.15]

6 Chronic lung disease in surviving infants(36 weeks post menstrual age) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.52, 2.42]

7 Necrotising enterocolitis Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.64]

7.1 Necrotising Enterocolitis‐Dexamethasone versus placebo	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Necrotising Enterocolitis‐Hydrocortisone versus placebo	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.64]
8 Gastric bleeding Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.64]

9 Gastrointestinal perforation Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.15]

10 Bacterial sepsis Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.29, 4.10]

10.1 Bacterial Sepsis‐Dexamethasone versus placebo	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.16, 3.41]
10.2 Bacterial Sepsis‐Hydrocortisone versus placebo	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 70.16]
11 Treatment failure Show forest plot	2	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.35 [0.19, 0.65]

Comparison 3. Steroid versus placebo or nothing (treatment of refractory hypotension)

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet