Statistics

Number of Journals8
Number of Issues47
Number of Articles342
Article View77,833
PDF Download49,623
Noorishadkam, M., Ekraminasab, S., Shams, S., Neamatzadeh, H. (2024). Budesonide-Surfactant Therapy for Neonatal Respiratory Distress Syndrome in Preterm Infants: A Systematic Review and Meta-Analysis of Respiratory Outcomes. Shahid Sadoughi University of Medical Sciences- Journal Management System, 7(1), 16-27. doi: 10.18502/wjpn.v7i1.17324
Mahmood Noorishadkam; Sedigheh Ekraminasab; Seyedeh Elham Shams; Hossein Neamatzadeh. "Budesonide-Surfactant Therapy for Neonatal Respiratory Distress Syndrome in Preterm Infants: A Systematic Review and Meta-Analysis of Respiratory Outcomes". Shahid Sadoughi University of Medical Sciences- Journal Management System, 7, 1, 2024, 16-27. doi: 10.18502/wjpn.v7i1.17324
Noorishadkam, M., Ekraminasab, S., Shams, S., Neamatzadeh, H. (2024). 'Budesonide-Surfactant Therapy for Neonatal Respiratory Distress Syndrome in Preterm Infants: A Systematic Review and Meta-Analysis of Respiratory Outcomes', Shahid Sadoughi University of Medical Sciences- Journal Management System, 7(1), pp. 16-27. doi: 10.18502/wjpn.v7i1.17324
Noorishadkam, M., Ekraminasab, S., Shams, S., Neamatzadeh, H. Budesonide-Surfactant Therapy for Neonatal Respiratory Distress Syndrome in Preterm Infants: A Systematic Review and Meta-Analysis of Respiratory Outcomes. Shahid Sadoughi University of Medical Sciences- Journal Management System, 2024; 7(1): 16-27. doi: 10.18502/wjpn.v7i1.17324

Budesonide-Surfactant Therapy for Neonatal Respiratory Distress Syndrome in Preterm Infants: A Systematic Review and Meta-Analysis of Respiratory Outcomes

World Journal of Peri and Neonatology
Article 4, Volume 7, Issue 1, December 2024, Pages 16-27    PDF (983.5 K)
Document Type: Original Article
DOI: 10.18502/wjpn.v7i1.17324
Authors
Mahmood Noorishadkam1; Sedigheh Ekraminasab* 2, 3; Seyedeh Elham Shams4; Hossein Neamatzadeh1
1Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Laboratory Hematology and Blood Banking Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences,
3Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Background: Neonatal respiratory distress syndrome (NRDS) in preterm infants is a critical condition often necessitating urgent medical intervention. This meta-analysis assesses the efficacy and safety of combining surfactant with budesonide for treating NRDS in preterm neonates, emphasizing respiratory outcomes.
Methods: We performed a systematic review of databases (PubMed, Embase, Cochrane Library) following PRISMA guidelines from inception to July 30, 2024. Studies comparing budesonide-surfactant combination therapy to surfactant alone in NRDS were included. Respiratory outcomes evaluated included duration of mechanical ventilation, continuous positive airway pressure (CPAP), length of hospitalization, and frequency of a second surfactant dose. The outcomes were the incidence of bronchopulmonary dysplasia (BPD) and mortality rates. Data from eligible studies were pooled for meta-analysis using a random-effects model.
Results: Ten articles involving 920 infants in the treatment group and 1167 in the control group were analyzed. The combination therapy significantly reduced mechanical ventilation time, hospitalization duration, and CPAP use and decreased the need for a second surfactant dose. The treatment group also showed significantly lower mortality rates (OR = 0.694, 95% CI: 0.52, 0.927, P < 0.05) and BPD incidence (OR = 0.639, 95% CI: 0.525, 0.778, P < 0.001) compared to controls.
Conclusion: Budesonide-surfactant therapy for NRDS in preterm infants effectively reduces mechanical ventilation time and hospitalization. It also significantly lowers mortality rates, the need for a second surfactant dose, and BPD incidence, indicating its potential for widespread application in NICUs. Further large-scale trials are needed to validate these findings and assess long-term outcomes.
Keywords
Pulmonary surfactant; Neonatal respiratory distress syndrome; Budesonide; Meta-analysis
References
  1. Golshan-Tafti M, Bahrami R, Dastgheib SA, Lookzadeh MH, Mirjalili SR, Yeganegi M, et al. A Comprehensive Compilation of Data on the Relationship Between Surfactant Protein-B (SFTPB) Polymorphisms and Susceptibility to Neonatal Respiratory Distress Syndrome. Fetal Pediatr Pathol 2024; 43(5): 399-418.
  2. Yadav S, Lee B, Kamity R. Neonatal respiratory distress syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
  3. Ekhaguere OA, Okonkwo IR, Batra M, Hedstrom AB. Respiratory distress syndrome management in resource limited settings-Current evidence and opportunities in 2022. Front Pediatr 2022; 10: 961509.
  4. Bahrami R, Golshan-Tafti M, Dastgheib SA, Alijanpour K, Yeganegi M, Lookzadeh MH, et al. A comprehensive consolidation of data on the relationship between Surfactant Protein-B (SFTPB) Polymorphisms and Susceptibility to Bronchopulmonary Dysplasia. Fetal Pediatr Pathol 2024; 43(6): 436-54.
  5. Daya A, Lookzadeh MH, Noorishadkam M, Mirjalili SR, Ekraminasab S. The effect of the iranian surfactant (Beraksurf) in the treatment of respiratory distress syndrome in premature neonates. World J Peri Neonatol 2023; 6(1): 10-6.
  6. Ng EH, Shah V. Guidelines for surfactant replacement therapy in neonates. Paediatr Child Health 2021; 26(1): 35-49.
  7. El-Gendy N, Kaviratna A, Berkland C, Dhar P. Delivery and performance of surfactant replacement therapies to treat pulmonary Ther Deliv 2013; 4(8): 951-80.
  8. Elfarargy MS, Al-Ashmawy GM, Abu-Risha SM, Khattab HA. Inhaled Budesonide in Neonatal Respiratory Distress Syndrome of Near-Term Neonates: A Randomized, Placebo-Controlled Trial. J Pediatr Pharmacol Ther 2022; 27(1): 38–44.
  9. Marzban A, Mokhtari S, Tavakkolian P, Mansouri R, Jafari N, Maleki A. The impact of combined administration of surfactant and intratracheal budesonide compared to surfactant alone on bronchopulmonary dysplasia (BPD) and mortality rate in preterm infants with respiratory distress syndrome: a single-blind randomized clinical. BMC Pediatr 2024; 24(1): 262.
  10. Moschino L, Nardo D, Bonadies L, Stocchero M, Res G, Priante E, et al. Intra-tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants. Pediatr Pulmonol 2021; 56(7): 2114–24.
  11. Yeh TF, Chen CM, Wu SY, Husan Z, Li TC, Hsieh WS, et al. Intratracheal administration of budesonide/surfactant to prevent bronchopulmonary dysplasia. Am J Respir Crit Care Med 2016; 193(1): 86–95.
  12. Gharehbaghi MM, Ganji S, Mahallei M. A randomized clinical trial of intratracheal administration of surfactant and budesonide combination in comparison to surfactant for prevention of bronchopulmonary dysplasia. Oman Med J 2021; 36(4): e289.
  13. Heo M, Jeon GW. Intratracheal administration of budesonide with surfactant in very low birth weight infants to prevent bronchopulmonary dysplasia. Turk J Pediatr 2020; 62(4): 551-9.
  14. Baghal Safa F, Noorishadkam M, Lookzadeh MH, Mirjalili SR, Ekraminasab S. Budesonide and Surfactant Combination for Treatment of Respiratory Distress Syndrome in Preterm Neonates and Evaluation Outcomes. J Clin Neonatol 2023; 12(4): 135–41.
  15. Marzban A, Mokhtari S, Tavakkolian P, Mansouri R, Jafari N, Maleki A. The impact of combined administration of surfactant and intratracheal budesonide compared to surfactant alone on bronchopulmonary dysplasia (BPD) and mortality rate in preterm infants with respiratory distress syndrome: a single-blind randomized clinical. BMC Pediatr 2024; 24(1): 262.
  16. Armanian AM, Iranpour R, Lotfi A, Amini R, Kahrizsangi NG, Jamshad A, et al. Intratracheal Administration of Budesonide-instilled Surfactant for Prevention of Bronchopulmonary Dysplasia: A Randomized Controlled Clinical Trial. Iran J Neonatol. 2023;14(4): 1-7.
  17. Kashaki M, Norouzi E, Daryasari AA, Maleki M, Farhanian F. Simultaneous intratracheal administration of surfactant and budesonide in the prevention of bronchopulmonary dysplasia in the treatment of respiratory distress syndrome in premature infants. Adv Life Sci 2023; 10(2): 304–8.
  18. Kothe TB, Sadiq FH, Burleyson N, Williams HL, Anderson C, Hillman NH. Surfactant and budesonide for respiratory distress syndrome: an observational study. Pediatr Res 2020; 87(5): 940–5.
  19. Anderson CD, Kothe TB, Josephsen JB, Sadiq FH, Burleyson N, Williams HL, et al. Budesonide mixed with surfactant did not affect neurodevelopmental outcomes at 6 or 18 months corrected age in observational cohorts. J Perinatol 2021; 41(7): 1681-9.
  20. Yi Z, Tan Y, Liu Y, Jiang L, Luo L, Wang L, et al. A systematic review and meta-analysis of pulmonary surfactant combined with budesonide in the treatment of neonatal respiratory distress syndrome. Transl Pediatr 2022; 11(4): 526-36.
  21. Manley BJ, Kamlin COF, Donath S, Huang L, Birch P, Cheong JLY, et al. Intratracheal budesonide mixed with surfactant to increase survival free of bronchopulmonary dysplasia in extremely preterm infants: study protocol for the international, multicenter, randomized PLUSS trial. Trials 2023; 24(1): 320.
  22. Yao Y, Zhang G, Wang F, Wang M. Efficacy of budesonide in the prevention and treatment of bronchopulmonary dysplasia in premature infants and its effect on pulmonary function. Am J Transl Res 2021; 13(5): 4949–58.
  23. Moraes LHA, Coelho RMD, Neves Dos Santos Beozzo GP, Yoshida R de AM, de Albuquerque Diniz EM, de Carvalho WB. Use of budesonide associated with a pulmonary surfactant to prevent bronchopulmonary dysplasia in premature newborns - A systematic review. J Pediatr (Rio J) 2023; 99(2): 105-11.
  24. Hillman NH, Kothe TB, Schmidt AF, Kemp MW, Royse E, Fee E, et al. Surfactant plus budesonide decreases lung and systemic responses to injurious ventilation in preterm sheep. Am J Physiol Lung Cell Mol Physiol 2020; 318(1): L41-L48.
  25. McEvoy CT, Ballard PL, Ward RM, Rower JE, Wadhawan R, Hudak ML, et al. Dose-escalation trial of budesonide in surfactant for prevention of bronchopulmonary dysplasia in extremely low gestational age high-risk newborns (SASSIE). Pediatr Res 2020; 88(4): 629-36. 
Statistics
Article View: 41
PDF Download: 45


Journal Management System. Powered by Sinaweb