Summary of findings 2. Familiar odour (breast milk smell) compared with standard care for pain during endotracheal suctioning.
| Familiar odour (breast milk smell) compared with standard care for pain during endotracheal suctioning | ||||||
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Patient or population: neonates with mechanical ventilation Settings: NICU Intervention: familiar odour (breast milk smell) Comparison: standard care | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Standard care | Familiar odour (breast milk smell) | |||||
| Validated pain scores | ||||||
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PIPP during endotracheal suctioning Range of scale 0 to 21. Lower score = less pain |
The mean PIPP during endotracheal suctioning in the control group was 11.4 | The mean PIPP during endotracheal suctioning in the intervention group was 0.30 lower | MD −0.30 (95% CI −2.15 to 1.55) | 40 (1) |
⊕⊕⊝⊝ Lowa, b | Familiar odour probably has little or no effect on PIPP score during endotracheal suctioning. |
| Physiological indicators | ||||||
| Heart rate | The mean heart rate during endotracheal suctioning in the control group was 153.9 bpm | The mean heart rate during endotracheal suctioning in the intervention group was 2.8 bpm higher | MD −6.30 bpm (95% CI −16.04 to 3.44) | 40 (1) | ⊕⊕⊝⊝ Lowa, b | Familiar odour probably has little or no effect on heart rate during endotracheal suctioning. |
| SaO 2 during endotracheal suctioning | The mean SaO 2 during endotracheal suctioning in the control group was 87.5% | The mean SaO 2 during endotracheal suctioning in the intervention group was 0.80% lower | MD −0.80% (95% CI −4.82 to 3.22) | 40 (1) |
⊕⊕⊝⊝ Lowa, b | Familiar odour probably has little or no effect on SaO 2 during endotracheal suctioning. |
| Behavioural indicators | ||||||
| — | — | — | — | — | — | No studies reported this outcome. |
| Intraventricular haemorrhage | ||||||
| — | — | — | — | — | — | No studies reported this outcome. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). **Coping with stress was considered as terminating the physical stress due to suctioning in infant, as characterised by achieving scores of 1 or 0 based on the Neonatal Infant Pain Scale. bpm: beats per minute; CI: confidence interval; MD: mean difference; NICU: neonatal intensive care unit; PIPP: Premature Infant Pain Profile; SaO 2 : oxygen saturation. | ||||||
| GRADE Working Group grades of evidence High certainty: further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: we are very uncertain about the estimate. | ||||||
a Downgraded one level because of severe study limitations (lack of blinding). b Downgraded one level because of imprecision.