Comparative efficacy of different single drugs to prevent necrotizing enterocolitis in preterm infants: an update systematic review and network meta-analysis

被引:0
|
作者
Chen, Jing [1 ]
Chen, Xiao [2 ]
Huang, Xiaoling [1 ]
Liu, Jia [1 ]
Yu, Qingfeng [1 ]
机构
[1] First Peoples Hosp Neijiang, Dept Neonatol, Neijiang, Peoples R China
[2] First Peoples Hosp Neijiang, Dept Orthoped, Neijiang, Peoples R China
来源
FRONTIERS IN NUTRITION | 2024年 / 11卷
关键词
preterm infants; necrotizing enterocolitis; drugs; network meta-analysis; randomized controlled trials; ENTERAL NUTRITION; PATHOGENESIS; IMPACT; EPIDEMIOLOGY; PROBIOTICS;
D O I
10.3389/fnut.2024.1452338
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Objective: To investigate an optimal regimen of six drugs, including lactoferrin, probiotics, prebiotics, glutamine, arginine and erythropoietin (EPO), for the prevention of necrotizing enterocolitis (NEC) in preterm infants. Methods: PubMed, Embase, Ovid, The Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) investigating the efficacy of lactoferrin, probiotics, prebiotics, glutamine, arginine, and EPO in preventing NEC in preterm infants, with a cutoff date of June 20, 2024. Two authors independently screened studies and extracted all the data. Network meta-analysis (NMA) was conducted to compare the outcomes of different interventions, and group rankings were determined using the surface under the cumulative ranking curve (SUCRA). Results: A total of 89 RCTs with 26,861 preterm infants were included. Arginine demonstrated the highest clinical efficacy in reducing the incidence of NEC, with probiotics being the next most effective and the placebo being the least effective. Lactoferrin was identified as the most effective intervention for reducing the incidence of NEC-associated sepsis. Prebiotics showed the highest effect on overall mortality, reducing the beginning of enteral feeding, and were associated with the shortest hospital stay. Glutamine significantly decreased the time to full enteral feeding. Conclusion: Existing literature highlights arginine as the most efficacious pharmacological agent in preventing NEC in preterm infants. It has been shown to effectively lower the rates of NEC, septicemia, and mortality, warranting its recommendation as the first-line clinical intervention. Following this, probiotics are recommended as a second option.
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页数:19
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