1. Populations and interventions in included trials.
|
Trial (no. infants) |
Antenatal steroids | Gestational age, weeks | Birth weight, grams | Device/Interface | Interventions/Controls | ||||
| SLI | Control | SLI | Control | SLI | Control | SLI and control | SLI | Control | |
| Abd 2017 (100) | 70% to 80% | 55% | 29.3 to 29.7 | 29.4 (SD 2.1) | 1363 to 1367 | mean 1249 (SD 363) | T‐piece | 4 different arms: PIP of either 15 or 20 cmH₂O for either 10 or 20 seconds | PEEP 5 cmH₂O, oxygen 30% |
| El‐Chimi 2017 (112) | 39% | 34.5% | mean 31.1 (SD 1.7) | mean 31.3 (SD 1.7) | mean 1561 (SD 326) | mean 1510 (SD 319) | Mask and T‐piece in SLI group Mask and self‐inflating bag with an oxygen reservoir in control group |
PIP of 20 cmH₂O for 15 seconds, followed by PEEP of 5 cmH₂O If needed: a second SLI of 15 seconds of 25 cmH₂O for 15 seconds, followed by PEEP of 6 cmH₂O; then a third SLI of 15 seconds of 30 cmH₂O for 15 seconds, followed by PEEP of 7 cmH₂O If still not satisfactory: intubated in delivery room |
PIP maximum 40 cmH₂O, rate of 40 to 60 breaths/min for 30 seconds |
| Jiravisitkul 2017 (81) | 63% | 74% | 25 to 28 weeks:
n = 17; 29 to 32 weeks: n = 26 |
25 to 28 weeks:
n = 16; 29 to 32 weeks: n = 22 |
mean 1206 (SD 367) | mean 1160 (SD 411) | Mask and T‐piece | PIP of 25 cmH₂O for 15 seconds If HR 60 to 100 beats/min and/or poor respiratory effort: a second SLI (25 cmH₂O, 15 seconds) |
PIP 15 to 20 cmH₂O, PEEP 5 cmH₂O for 30 seconds, followed by resuscitation according to AHA guidelines |
| Kirpalani 2019 (426) | 97% | 97% | 23 to 24 weeks: n = 76; 25 to 26 weeks: n = 139 |
23 to 24 weeks: n = 75; 25 to 26 weeks: n = 136 |
median 725 (IQR 620 to 855) | median 731 (IQR 630 to 854) | Either mask or a nasopharyngeal tube (as unit protocol dictated) and T‐piece resuscitator | PIP of 20 cmH₂O for 15 seconds. If needed: a second SLI of 15 seconds of 25 cmH₂O |
PIP with PEEP |
| Lindner 2005 (61) | 81% | 80% | median 27.0 (IQR 25.0 to 28.9) | median 26.7 (IQR 25.0 to 28.9) | median 870 (IQR 410 to 1320) | median 830 (IQR 370 to 1370) | Nasopharyngeal tube (fixed at 4 to 5 cm) and mechanical ventilator | PIP of 20 cmH₂O for 15 seconds If response was not satisfactory: 2 further SLIs of 15 seconds (25 and 30 cmH₂O). Then PEEP at 4 to 6 cmH₂O |
PIP 20 cmH₂O, PEEP 4 to 6 cmH₂O; inflation time 0.5 seconds; inflation rate 60 per min. Then, PEEP at 4 to 6 cmH₂O |
| Lista 2015 (301) | 87% | 91% | mean 26.8 (SD 1.2); 25 to 26 weeks: n = 55 27 to 28 weeks: n = 88 |
mean 26.8 (SD 1.1); 25 to 26 weeks: n = 52; 27 to 28 weeks: n = 96 |
mean 894 (SD 247) | mean 893 (SD 241) | Mask and T‐piece | PIP 25 cmH₂O for 15 seconds. Then reduced to PEEP of 5 cmH₂O | PEEP 5 cmH₂O, followed by resuscitation according to AHA guidelines |
| Mercadante 2016 (185) | 40% | 32% | mean 35.2 (SD 0.8) | mean 35.2 (SD 0.8) | mean 2345 (SD 397) | mean 2346 (SD 359) | Mask and T‐piece | PIP 25 cmH₂O for 15 seconds, followed by PEEP of 5 cmH₂O. In case of persistent heart failure (HR < 100 bpm): SLI repeated | PEEP 5 cmH₂O, followed by resuscitation according to AAP guidelines |
| Ngan 2017 (162) | 78% | 70% | mean 28 (SD 2.5) | mean 28 (SD 2.5) | mean 1154 (SD 426) | mean 1140 (SD 406) | Mask and T‐piece | Two PIPs of 24 cmH₂O. Duration of first SLI was 20 seconds. Duration of second SLI was 20 or 10 seconds, guided by ECO₂ values. After SLIs, CPAP if breathing spontaneously or, if found to have apnoea or laboured breathing, mask IPPV at a rate of 40 to 60 bpm | IPPV, rate of 40 to 60 inflations/min until spontaneous breathing, at which time CPAP will be provided |
| Schmölzer 2018 (9) | 80%a | 100%a | mean 24.6 (SD 1.3)a | mean 25.6 (SD 2.3)a | mean 707 (SD 208)a | mean 808 (SD 192)a | Mask and T‐piecea | PIP for 20 + 20 secondsa during chest compressions | 3:1 compression:ventilation ratio according to resuscitation guidelines |
| Schwaberger 2015 (40) | not reported | not reported | mean 32.1 (SD 1.4) | mean 32.1 (SD 1.6) | mean 1692 (SD 297) | mean 1722 (SD 604) | Mask and T‐piece | PIP 30 cmH₂O for 15 seconds, to be repeated once or twice with HR remaining < 100 bpm. Infants with HR > 100 bpm: PPV at 30 cmH₂O PIP or CPAP at PEEP level of 5 cmH₂O depending on respiratory rate | Resuscitation according to AHA guidelines PEEP 5 cmH₂O if respiratory rate > 30 and signs of respiratory distress PPV at 30 cmH₂O PIP if insufficient breathing efforts |
aInformation provided by study authors