Journal article
Efficacy of intratracheal budesonide plus surfactant vs. surfactant alone on bronchopulmonary dysplasia in preterm infants: A meta-analysis of randomized controlled trials
Paediatric respiratory reviews
03 Mar 2025
Abstract
[Display omitted]
Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disease commonly affecting very preterm infants. The potential benefits of combining budesonide with surfactant for preterms with early BPD remain uncertain and warrant further exploration.
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of intratracheal budesonide plus surfactant compared with surfactant alone in very preterm infants.
We searched PubMed, Embase and Cochrane Central databases from inception to November 2024. We conducted a meta-analysis following the PRISMA guidelines. We calculated the risk ratios (RRs) of endpoints of interest with 95% confidence intervals using a random effects model. R software (version 4.3.2) was used for statistical analyses. Heterogeneity was assessed with I2 statistics.
Eight RCTs including 2029 preterm infants were included. Compared with surfactant alone, a combined intratracheal budesonide plus surfactant significantly reduced the risk of bronchopulmonary dysplasia (RR: 0.72; 95 % CI: 0.55–0.94; p = 0.016; I2 = 73.5 %), mortality (RR: 0.73; 95 % CI: 0.54–0.99; p = 0.041; I2 = 21.3 %), pulmonary hemorrhage (RR: 0.58; 95 % CI: 0.37–0.90; p = 0.015; I2 = 0 %) and patent ductus arteriosus (RR: 0.84; 95 % CI: 0.75–0.94; p = 0.004; I2 = 0 %).
This meta-analysis found that intratracheal budesonide plus surfactant reduces the risk of bronchopulmonary dysplasia, mortality, pulmonary hemorrhage and patent ductus arteriosus compared with surfactant alone. Given its potential to reduce pulmonary complications associated with prematurity, clinicians may consider this combination therapy.
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Details
- Title
- Efficacy of intratracheal budesonide plus surfactant vs. surfactant alone on bronchopulmonary dysplasia in preterm infants: A meta-analysis of randomized controlled trials
- Creators
- Aluisio D’lucas Alves Gomes - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilElísio Bulhões - Faculty of Higher Superior of the Amazon Reunida, Medicine Department, Redenção, Pará, BrazilDanielle Costa do Amaral - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilLuis Felipe Matos de Sousa - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilEly Cavalcante Lima Júnior - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilJosé Airton Alves Ferreira - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilHilderlania Alves de Oliveira - Federal University of Ceará, Medicine Department, Sobral, Ceará, BrazilMaria L.R. Defante - Redentor University Center, Medicine Department, Itaperuna, Rio de Janeiro, BrazilJafar Aljazeeri - University of Pittsburgh Medical Center
- Publication Details
- Paediatric respiratory reviews
- Publisher
- Elsevier Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pulmonary, Critical Care, and Sleep (Medicine)
- Scopus ID
- 2-s2.0-105005443652
- Other Identifier
- 991022041141504721