Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis

Objectiveto compare surfactant administration via supraglottic airway device (sad) vs. nasal cpap alone or insure.study designa systematic search of pubmed, embase, scopus, cochrane central register of controlled trials and clinicaltrials.gov was performed. articles meeting inclusion criteria (rct, surfactant administration via sad, laryngeal mask, i-gel) were assessedresultsfive rcts were eligible. surfactant administration via sad reduced the need for intubation/mechanical ventilation (rr 0.57, 95%ci 0.38–0.85) and short-term oxygen requirements (md −8.00, 95%ci −11.09 to −4.91) compared to ncpap alone. surfactant administration via sad reduced the need for intubation/mechanical ventilation (rr 0.43, 95%ci 0.31–0.61), but increased short-term oxygen requirements (md 3.10, 95%ci 0.51–5.69) compared to insure approach.conclusionsin preterm infants with rds, surfactant administration via sad reduces the need for intubation/mechanical ventilation. overall, available literature includes few, small, poor-quality studies. surfactant administration via sad should be limited to clinical trials.