{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:41:55Z","timestamp":1760139715851,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (RCTs). We used relative risk (RR) and mean difference (MD) with 95% confidence intervals (95%CI) to assess the effect on dichotomous and continuous outcomes, respectively. In addition, we used the Paule\u2013Mandel (PM) random effects model due to the anticipated lack of events. Results: Three RCTs were included (n = 432). No significant difference was found in mortality (RR = 0.82; 95%CI = 0.54\u20131.25; I2 = 71%; p = 0.36), need for ventilation (RR = 0.49; 95%CI = 0.15\u20131.56; I2 = 71%; p = 0.57), and incidence of pneumothorax (RR = 1.24; 95%CI = 0.30\u20135.12; I2 = 0%; p = 0.77) in the CPAP group compared to the ETI group. Regarding secondary outcomes, compared to the ETI group, no significant differences were found in APGAR at one minute (MD = \u22121.01; 95%CI \u22122.97 to 0.94; I2 = 98%; p = 0.31), APGAR at 5 min (MD = \u22121.00; 95%CI = \u22122.96 to 0.95; I2 = 99%; p = 0.32), days of hospitalization (MD = \u22120.52; 95%CI = \u22121.46 to 0.42; I2 = 94%; p = 0.28), and cord pH (MD = 0.003; 95%CI = \u22120.01 to 0.02; I2 = 0%; p = 0.79). Conclusions: In patients with MAS, there is no significant effect of CPAP use compared to ETI on primary, specifically on mortality, need for ventilation, the incidence of pneumothorax, and secondary outcomes.<\/jats:p>","DOI":"10.3390\/children9050589","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T05:07:22Z","timestamp":1650604042000},"page":"589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4664-2856","authenticated-orcid":false,"given":"Carlos J.","family":"Toro-Huamanchumo","sequence":"first","affiliation":[{"name":"Facultad de Ciencias de la Salud, Escuela de Medicina, Universidad C\u00e9sar Vallejo, Trujillo 13007, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryori M.","family":"Hilario-Gomez","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de San Fernando, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"Diaz-Reyes","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Peruana Uni\u00f3n, Lima 15081, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 A.","family":"Caballero-Alvarado","sequence":"additional","affiliation":[{"name":"Escuela de Postgrado, Universidad Privada Antenor Orrego, Trujillo 13007, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2896-1407","authenticated-orcid":false,"given":"Joshuan J.","family":"Barboza","sequence":"additional","affiliation":[{"name":"Unidad de Revisiones Sistem\u00e1ticas y Meta-An\u00e1lisis (URSIGET), Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola, Lima 15081, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8489","DOI":"10.14260\/jemds\/2015\/1231","article-title":"A Prospective Study of Meconium Aspiration Syndrome in Newborns in a District Hospital in Southern India","volume":"4","author":"Vijayalakshmi","year":"2015","journal-title":"J. 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