Summary of findings for the main comparison. Inhaled NO compared with control for respiratory failure in preterm infants.
| Inhaled NO compared with control for respiratory failure in preterm infants | ||||||
| Patient or population: respiratory failure in preterm infants Setting: neonatal intensive care units Intervention: inhaled NO Comparison: placebo or no treatment | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with placebo or no treatment | Risk with Inhaled NO | |||||
| Death before discharge ‐ Studies with entry before 3 days based on oxygenation | Study population | RR 1.02 (0.89 to 1.18) | 1066 (10 RCTs) | ⊕⊕⊕⊕ High | ||
| 394 per 1000 | 402 per 1000 (351 to 465) | |||||
| Death before discharge ‐ Studies with entry after 3 days based on BPD risk | Study population | RR 1.18 (0.81 to 1.71) | 1075 (3 RCTs) | ⊕⊕⊕⊕ High | ||
| 83 per 1000 | 98 per 1000 (67 to 141) | |||||
| Death before discharge ‐ Studies of routine use in preterm infants on respiratory support | Study population | RR 0.90 (0.74 to 1.10) | 1924 (4 RCTs) | ⊕⊕⊕⊝ Moderatea | ||
| 170 per 1000 | 153 per 1000 (126 to 187) | |||||
| Death or bronchopulmonary dysplasia at 36 weeks ‐ Studies with entry before 3 days based on oxygenation | Study population | RR 0.94 (0.87 to 1.01) | 958 (8 RCTs) | ⊕⊕⊕⊕ High | ||
| 743 per 1000 | 698 per 1000 (646 to 750) | |||||
| Death or bronchopulmonary dysplasia at 36 weeks ‐ Studies with entry after 3 days based on BPD risk | Study population | RR 0.92 (0.85 to 1.01) | 1075 (3 RCTs) | ⊕⊕⊕⊕ High | ||
| 667 per 1000 | 614 per 1000 (567 to 674) | |||||
| Death or bronchopulmonary dysplasia at 36 weeks ‐ Studies of routine use in preterm infants on respiratory support | Study population | RR 0.94 (0.87 to 1.02) | 1924 (4 RCTs) | ⊕⊕⊕⊕ High | ||
| 548 per 1000 | 515 per 1000 (477 to 559) | |||||
| Intraventricular haemorrhage (grade 3 or 4) ‐ Studies with entry before 3 days based on oxygenation | Study population | RR 1.20 (0.98 to 1.47) | 773 (6 RCTs) | ⊕⊕⊕⊕ High | ||
| 231 per 1000 | 278 per 1000 (227 to 340) | |||||
| Intraventricular haemorrhage (grade 3 or 4) ‐ Studies of routine use in preterm infants on respiratory support | Study population | RR 0.89 (0.73 to 1.09) | 1913 (4 RCTs) | ⊕⊕⊕⊝ Moderateb | ||
| 127 per 1000 | 113 per 1000 (93 to 139) | |||||
| Neurodevelopmental disability ‐ Studies with entry before 3 days based on oxygenation | Study population | RR 1.05 (0.78 to 1.40) | 208 (2 RCTs) | ⊕⊕⊕⊝ Moderatec | ||
| 455 per 1000 | 477 per 1000 (355 to 636) | |||||
| Neurodevelopmental disability ‐ Studies with entry after 3 days based on BPD risk | Study population | RR 0.90 (0.74 to 1.09) | 498 (2 RCTs) | ⊕⊕⊕⊝ Moderatec | ||
| 480 per 1000 | 432 per 1000 (355 to 523) | |||||
| Neurodevelopmental disability ‐ Studies of routine use in preterm infants on respiratory support | Study population | RR 0.91 (0.74 to 1.13) | 1223 (3 RCTs) | ⊕⊕⊕⊕ High | ||
| 195 per 1000 | 178 per 1000 (144 to 220) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: We are very confident that the true effect lies close to that of the estimate of effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
aHighly variable risk ratio in individual trials (I2 = 50%).
bHighly variable risk ratio in individual trials (I2 = 33%).
cBased on 2 studies, wide confidence intervals.