Summary of findings 4. Morphine compared to diamorphine for neonates receiving mechanical ventilation.
| Morphine compared to diamorphine for neonates receiving mechanical ventilation | ||||||
| Patient or population: neonates receiving mechanical ventilation Setting: neonatal intensive care unit in the UK (Wood 1998) Intervention: morphine Comparison: diamorphine | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | №. of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with diamorphine | Risk with morphine | |||||
| Pain (PIPP) | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| Duration of mechanical ventilation (days) | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| Neonatal mortality | Study population | RR 1.17 (0.43 to 3.19) | 88 (1 RCT) | ⊕⊝⊝⊝ VERY LOW | Serious imprecision of the estimatesa and indirectness | |
| 136 per 1000 | 160 per 1000 (59 to 435) | |||||
| Mortality before discharge | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| Neurodevelopmental outcomes (18 to 24 months) | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| Neurodevelopmental outcomes (3 to 5 years) | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| Neurodevelopmental outcomes (5 to 6 years) | See comment | See comment | Not estimable | Not reported | Not estimable | None of the studies reported on this outcome |
| *The risk in the intervention group (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). CI: confidence interval; PIPP: Premature Infant Pain Profile; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aFor "serious imprecision", downgraded by two levels.