Mohammad Tanashat, AlMothana Manasrah, Omar Abdullah Bataineh, Ahmad Abdelrazek, Mohamed Abouzid
{"title":"气泡持续气道正压治疗1-59月龄儿童重症肺炎和低氧血症的有效性:随机对照试验的系统评价和荟萃分析","authors":"Mohammad Tanashat, AlMothana Manasrah, Omar Abdullah Bataineh, Ahmad Abdelrazek, Mohamed Abouzid","doi":"10.1007/s13312-025-00081-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Continuous positive airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ventilators are often unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effective and less invasive alternative to CPAP, however, its efficacy has not been assessed for children with pneumonia until recently. This meta-analysis aims to compare the effectiveness of bCPAP with low-flow oxygen for treating severe pneumonia and hypoxemia in children.</p><p><strong>Methods: </strong>PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to identify eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager software. P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Three studies with 2030 patients were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (- 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ventilation [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048].</p><p><strong>Conclusion: </strong>bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ventilation decreases.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"440-450"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 1-59 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.\",\"authors\":\"Mohammad Tanashat, AlMothana Manasrah, Omar Abdullah Bataineh, Ahmad Abdelrazek, Mohamed Abouzid\",\"doi\":\"10.1007/s13312-025-00081-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Continuous positive airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ventilators are often unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effective and less invasive alternative to CPAP, however, its efficacy has not been assessed for children with pneumonia until recently. This meta-analysis aims to compare the effectiveness of bCPAP with low-flow oxygen for treating severe pneumonia and hypoxemia in children.</p><p><strong>Methods: </strong>PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to identify eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager software. P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Three studies with 2030 patients were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (- 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ventilation [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048].</p><p><strong>Conclusion: </strong>bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ventilation decreases.</p>\",\"PeriodicalId\":13291,\"journal\":{\"name\":\"Indian pediatrics\",\"volume\":\" \",\"pages\":\"440-450\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13312-025-00081-x\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13312-025-00081-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 1-59 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Objective: Continuous positive airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ventilators are often unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effective and less invasive alternative to CPAP, however, its efficacy has not been assessed for children with pneumonia until recently. This meta-analysis aims to compare the effectiveness of bCPAP with low-flow oxygen for treating severe pneumonia and hypoxemia in children.
Methods: PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to identify eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager software. P value < 0.05 was considered statistically significant.
Results: Three studies with 2030 patients were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (- 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ventilation [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048].
Conclusion: bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ventilation decreases.
期刊介绍:
The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are:
-To publish original, relevant, well researched peer reviewed articles on issues related to child health.
-To provide continuing education to support informed clinical decisions and research.
-To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics.
-To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.