SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Neuroendoscopic lavage for the management of neonatal post-haemorrhagic hydrocephalus: A systematic review and meta-analysis.
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07733778 (Role of Neuro-endoscopic Lavage in the Management of Neonatal Intra-ventricular Hemorrhage), which is not on this map. Cited by 1 paper.
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Role of Neuro-endoscopic Lavage in the Management of Neonatal Intra-ventricular Hemorrhage
Who cites it
1 citing paper in PubMed.
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeNeuroendoscopic lavage (NEL) has gained interest for the management of neonatal intraventricular haemorrhage (IVH) as a method for intraventricular haematoma and debris removal. However, evidence regarding efficacy, safety, and long-term outcomes remains limited and heterogeneous. A systematic synthesis of the available literature is warranted to evaluate potential efficacy and complication rates following NEL compared to conventional management strategies.
methodsWe carried out a systematic review and meta-analysis of original studies assessing outcomes for patients with neonatal IVH managed with NEL. Medline, Embase and Pubmed were searched from inception to 1st of April 2025. Outcomes included: shunt dependence, cerebrospinal fluid leak, post-procedure infection, rate of rebleed and neurodevelopmental outcomes.
results11 papers, encompassing 9 studies were included, with a cohort of 299 patients who underwent NEL. Following NEL the pooled shunt-dependence rate was 66.0% (95% CI:0.57-0.74) and the infection rate was 7.4% (95% CI: 0.02-0.13). The odds ratio (OR) of shunt-dependence with NEL compared to standard treatment (ventricular access device, ventriculo-subgaleal shunting or external ventricular drain) was 0.51 (95%CI:0.25-1.05, p = 0.07). There was a significantly reduced risk of post-operative infection with NEL compared to standard treatment (0.14, 95%CI: 0.06-0.34, p < 0.0001). 69.1% of patients achieved a "good" Gross Motor Functional Classification Score (1-2) following NEL.
conclusionsNEL appears to offer favourable outcomes for the management of neonatal IVH, with a potential reduction in the risk of shunt-dependence and a lower risk of infection than presented by VSGSs or VADs. Robust, high-quality data are needed to better establish NEL's definitive role in the therapeutic algorithm for neonatal IVH.
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