Abstract：
Superior vena cava (SVC) flow has been considered a surrogate marker of systemic blood flow in neonates. We conducted a systematic review to evaluate the association between low SVC flow recorded during the early neonatal period and neonatal outcomes. We searched the following databases (until December 9, 2020; updated October 21, 2022): PROSPERO, OVID Medline, OVID EMBASE, Cochrane Library (CDSR and Central), Proquest Dissertations and Theses Global, and SCOPUS using controlled vocabulary and key words representing the concepts \"superior vena cava\" and \"flow\" and \"neonate.\" Results were exported to COVIDENCE review management software. The search retrieved 593 records after the removal of duplicates, of which 11 studies (nine cohorts) met the inclusion criteria. The majority of the studies included infants born at <30 weeks of gestation. The included studies were assessed as high risk of bias in terms of the incomparability of the study groups, with infants in the low SVC flow group noted to be more immature than those in the normal SVC flow group or subjected to different cointerventions. We did not conduct meta-analyses in view of the significant clinical heterogeneity noted in the included studies. We found little evidence to suggest that SVC flow in the early neonatal period is an independent predictor for adverse clinical outcomes in preterm infants. Included studies were assessed at high risk of bias. We conclude that SVC flow interpretation for prognostication or for making treatment decisions should be restricted to the research setting for now. We highlight the need for strengthened methods in future research studies. KEY POINTS: · We studied whether low SVC flow in the early neonatal period is a marker for adverse outcomes in preterm infants.. · There is insufficient evidence to conclude that low SVC flow is a valid predictor of adverse outcomes.. · There is insufficient evidence to conclude that SVC flow-directed hemodynamic management improves clinical outcomes..
摘要：
背景：上腔静脉（SVC）流量已被认为是新生儿全身血流的替代指标。我们进行了系统评价，以评估新生儿早期记录的低SVC流量与新生儿结局之间的关系。
方法：我们搜索了以下数据库（直到2020年12月9日；更新于2022年10月21日）：PROSPERO，OVIDMedline,OVIDEMBASE,Cochrane图书馆（CDSR和中央），Proquest学位论文和论文全球，和SCOPUS使用控制的词汇和关键词代表概念“上腔静脉”和“流量”和“新生儿”。结果导出到COVIDENCE审查管理软件。
结果：删除重复项后，搜索检索到593条记录，其中11项研究(9个队列)符合纳入标准.大多数研究包括妊娠<30周出生的婴儿。就研究组的不可比性而言，纳入的研究被评估为高偏倚风险，低SVC流量组的婴儿比正常SVC流量组的婴儿更不成熟或接受不同的共同干预措施。鉴于纳入研究中发现的显著临床异质性，我们没有进行荟萃分析。
结论：我们发现几乎没有证据表明新生儿早期SVC流量是早产儿不良临床结局的独立预测因子。纳入的研究被评估为偏倚的高风险。目前，用于预测或制定治疗决策的SVC流量解释应仅限于研究环境。我们强调在未来的研究中需要加强方法。
方法：我们搜索了以下数据库（直到2020年12月9日；更新于2022年10月21日）：PROSPERO，OVIDMedline,OVIDEMBASE,Cochrane图书馆（CDSR和中央），Proquest学位论文和论文全球，和SCOPUS使用控制的词汇和关键词代表概念“上腔静脉”和“流量”和“新生儿”。结果导出到COVIDENCE审查管理软件。
结果：删除重复项后，搜索检索到593条记录，其中11项研究(9个队列)符合纳入标准.大多数研究包括妊娠<30周出生的婴儿。就研究组的不可比性而言，纳入的研究被评估为高偏倚风险，低SVC流量组的婴儿比正常SVC流量组的婴儿更不成熟或接受不同的共同干预措施。鉴于纳入研究中发现的显著临床异质性，我们没有进行荟萃分析。
结论：我们发现几乎没有证据表明新生儿早期SVC流量是早产儿不良临床结局的独立预测因子。纳入的研究被评估为偏倚的高风险。目前，用于预测或制定治疗决策的SVC流量解释应仅限于研究环境。我们强调在未来的研究中需要加强方法。
