TY - JOUR
T1 - NET work M eta-analysis of T rials of i nitial O xygen in preterm N ewborns (NETMOTION)
T2 - A Protocol for Systematic Review and Individual Participant Data Network Meta-Analysis of Preterm Infants <32 Weeks' Gestation Randomized to Initial Oxygen Concentration for Resuscitation
AU - Sotiropoulos, James X.
AU - Oei, Ju Lee
AU - Schmölzer, Georg M.
AU - Hunter, Kylie E.
AU - Williams, Jonathan G.
AU - Webster, Angela C.
AU - Vento, Maximo
AU - Kapadia, Vishal
AU - Rabi, Yacov
AU - Dekker, Janneke
AU - Vermeulen, Marijn J.
AU - Sundaram, Venkataseshan
AU - Kumar, Praveen
AU - Saugstad, Ola D.
AU - Seidler, Anna Lene
N1 - Funding Information:
A.L. Seidler is funded by a National Health and Medical Research Council Investigator Grant Fellowship (GNT 2009432).
Publisher Copyright:
© 2022
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Background: Internationally recognized guidelines recommend the judicious use of low oxygen (21-30%), titrated to peripheral oxygen saturation targets, for the initiation of resuscitation of very and extremely preterm infants (<32 weeks' gestation). However, despite more than 10 randomized controlled trials on this question, the ideal initial oxygen concentration for this group of vulnerable infants remains uncertain. Aims: This study aims to assess the effect of various initial oxygen concentrations on (1) all-cause mortality, chronic lung disease, intraventricular hemorrhage, and retinopathy of prematurity; and (2) reaching the prescribed oxygen saturation targets by 5 min after birth, in preterm infants requiring resuscitation. Methods: We will conduct a systematic review and network meta-analysis using individual participant data. Studies of preterm infants <32 weeks' gestation, randomized to initial oxygen concentration, will be included. We will systematically search medical databases and trial registries for eligible studies (published or unpublished). Records will be screened by two independent reviewers, with conflicts resolved by the inclusion of a third reviewer. Identified initial oxygen concentrations will be grouped into the following nodes: low (≤30%), intermediate (60%), and high (≥90%) oxygen. A two-step random-effects contrast-based network meta-regression will be calculated to compare and rank different oxygen concentrations. Analyses will be intention-to-treat, with the primary outcome of all-cause mortality. Discussion: This is the first individual participant data network meta-analysis of initial oxygen concentrations for the resuscitation of preterm infants. This novel approach may address long-standing uncertainty regarding optimal oxygen supplementation practice for the resuscitation of preterm infants <32 weeks' gestation.
AB - Background: Internationally recognized guidelines recommend the judicious use of low oxygen (21-30%), titrated to peripheral oxygen saturation targets, for the initiation of resuscitation of very and extremely preterm infants (<32 weeks' gestation). However, despite more than 10 randomized controlled trials on this question, the ideal initial oxygen concentration for this group of vulnerable infants remains uncertain. Aims: This study aims to assess the effect of various initial oxygen concentrations on (1) all-cause mortality, chronic lung disease, intraventricular hemorrhage, and retinopathy of prematurity; and (2) reaching the prescribed oxygen saturation targets by 5 min after birth, in preterm infants requiring resuscitation. Methods: We will conduct a systematic review and network meta-analysis using individual participant data. Studies of preterm infants <32 weeks' gestation, randomized to initial oxygen concentration, will be included. We will systematically search medical databases and trial registries for eligible studies (published or unpublished). Records will be screened by two independent reviewers, with conflicts resolved by the inclusion of a third reviewer. Identified initial oxygen concentrations will be grouped into the following nodes: low (≤30%), intermediate (60%), and high (≥90%) oxygen. A two-step random-effects contrast-based network meta-regression will be calculated to compare and rank different oxygen concentrations. Analyses will be intention-to-treat, with the primary outcome of all-cause mortality. Discussion: This is the first individual participant data network meta-analysis of initial oxygen concentrations for the resuscitation of preterm infants. This novel approach may address long-standing uncertainty regarding optimal oxygen supplementation practice for the resuscitation of preterm infants <32 weeks' gestation.
KW - Individual participant data meta-analysis
KW - Neonatal resuscitation
KW - Network meta-analysis
KW - Oxygen concentration
KW - Preterm birth
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U2 - 10.1159/000525127
DO - 10.1159/000525127
M3 - Review article
C2 - 35785768
AN - SCOPUS:85134721047
SN - 1661-7800
VL - 119
SP - 517
EP - 524
JO - Neonatology
JF - Neonatology
IS - 4
ER -