3 | RESULTS
3.1 | Study
selection and characteristics of included studies
A total of 915 studies were obtained during the initial search.
Subsequently, 371 duplicates were distinguished and excluded with
Endnote software. From the remaining 544 articles, 496 articles were
exempted after scanning titles and abstracts. Finally, 35 articles were
excluded after reading the full text, and 13 articles14-26 were included in the meta-analysis with a total
of 1931 infants, including 964 in the MISA group and 967 in the control
group.
The control groups in two articles 14,19 chose
mechanical ventilation after intubation for surfactant delivery, whereas
the intervention groups in 11 articles 15-18,20-26chose INSURE techniques. The MISA techniques used in the intervention
groups were as follows: eight articles 14,16-20,22,26used LISA techniques, two articles 21,24 used MIST
techniques, two articles 23,25 used both techniques,
and one article 15 only mentioned administration of a
surfactant via a thin catheter but did not specify which technique was
used.
The application of cesarean sections and antenatal steroids was similar
between the two groups in each study. All studies described similar
criteria for surfactant delivery with similar values of fractional
oxygen inhalation (FiO2) and/or respiratory distress
severity, whereas 12 articles 14,16-26 described
criteria for rescue intubation. In ten articles14-21,24,26, the type of pulmonary surfactant was
Curosurf, whereas in three articles 22,23,25, three
other kinds of pulmonary surfactant were used. The literature screening
process is shown in Figure 1, and the basic characteristics of the
included studies are given in Table 1.