未经授权:出生时上呼吸道抽吸被认为是标准程序,并且仍然普遍使用。负面影响可能超过吸力的好处。
UNASSIGNED:在通过透明羊水(P)出生的婴儿中,口鼻吸入(I)和无吸入(C)可以改善结局(O)。
UNASSIGNED:信息专家使用Medline进行了文献检索(2021年9月12日,2022年6月17日重新运行),Embase,Cochrane数据库,效果评论摘要数据库,和CINAHL。RCT,纳入了非随机对照试验和具有明确选择策略的观察性研究.未发表的研究,reviews,社论,动物和人体模型研究被排除在外.
未经评估:两位作者独立提取数据,使用CochraneROB2和ROBINS-I工具评估偏倚风险.使用等级框架评估了证据的确定性。ReviewManager用于分析数据,GRADEPro用于开发证据表摘要。如果≥2个RCTs可用,则进行Meta分析。
UNASSIGNED:主要:辅助通气。次要:高级复苏,氧气补充,吸痰的不利影响,意外的NICU入院。
未经评估:确定了9项随机对照试验(n=1096)和2项观察性研究(n=418)。事后排除了两个有数据问题的RCT(n=280)。3项随机对照试验的Meta分析,(n=702)在主要结局方面没有差异。两项RCT(n=200)和2项前瞻性观察性研究(n=418)发现,在吸气的前10分钟内,氧饱和度较低。两个RCT(n=200)显示,吸入的新生儿需要更长的时间才能达到目标饱和度。
未经评估:所有结果的证据确定性都很低或很低。大多数研究选择了健康的新生儿,限制了普适性,并且没有足够的数据可用于计划的亚组分析。
未经批准:尽管证据不确定,这篇综述表明,从出生后的婴儿中吸取羊水没有临床益处,一些证据表明结果是去饱和。这些发现支持当前的指南建议,即这种做法不被用作分娩的常规步骤。
UNASIGNED:国际复苏联络委员会提供了对软件平台的访问,信息专家和电话会议。
UNASSIGNED:此系统审查已在系统审查前瞻性登记册(https://www。crd.约克。AC.uk/prospro/)(标识符:CRD42021286258)。
UNASSIGNED: Upper airway suctioning at birth was considered standard procedure and is still commonly practiced. Negative effects could exceed benefits of suction.
UNASSIGNED: In infants born through clear amniotic fluid (P) does suctioning of the mouth and nose (I) vs no suctioning (C) improve outcomes (O).
UNASSIGNED: Information specialist conducted literature search (12th September 2021, re-run 17th June 2022) using Medline, Embase, Cochrane Databases, Database of Abstracts of Reviews of Effects, and CINAHL. RCTs, non-RCTs and observational studies with a defined selection strategy were included. Unpublished studies, reviews, editorials, animal and manikin studies were excluded.
UNASSIGNED: Two authors independently extracted data, risk of bias was assessed using the Cochrane ROB2 and ROBINS-I tools. Certainty of evidence was assed using the GRADE framework. Review Manager was used to analyse data and GRADEPro to develop summary of evidence tables. Meta-analyses were performed if ≥2 RCTs were available.
UNASSIGNED: Primary: assisted ventilation. Secondary: advanced resuscitation, oxygen supplementation, adverse effects of suctioning, unanticipated NICU admission.
UNASSIGNED: Nine RCTs (n = 1096) and 2 observational studies (n = 418) were identified. Two RCTs (n = 280) with data concerns were excluded post-hoc. Meta-analysis of 3 RCTs, (n = 702) showed no difference in primary outcome. Two RCTs (n = 200) and 2 prospective observational studies (n = 418) found lower oxygen saturations in first 10 minutes of life with suctioning. Two RCTs (n = 200) showed suctioned newborns took longer to achieve target saturations.
UNASSIGNED: Certainty of evidence was low or very low for all outcomes. Most studies selected healthy newborns limiting generalisability and insufficient data was available for planned subgroup analyses.
UNASSIGNED: Despite low certainty evidence, this review suggests no clinical benefit from suctioning clear amniotic fluid from infants following birth, with some evidence suggesting a resulting desaturation. These finding support current guideline recommendations that this practice is not used as a routine step in birth.
UNASSIGNED: The International Liaison Committee on Resuscitation provided access to software platforms, an information specialist and teleconferencing.
UNASSIGNED: This systematic review was registered with the Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/prospero/) (identifier: CRD42021286258).