SynthesisPediatric research2026
Primary preventive interventions to reduce ventilator-associated pneumonia in neonatal intensive care units: a meta-analysis.
Synthesis in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundTo assess preventive strategies for ventilator-associated pneumonia (VAP) in mechanically ventilated (MV) neonates.
methodsPubMed, Embase, Web of Science, and Cochrane Library were searched in June 2025. Eligible studies evaluated primary VAP-prevention interventions in neonates receiving MV. Outcomes included odds ratios (ORs), incidence rate ratios (IRRs), and incidence rate differences (IRDs).
resultsThirty-four studies involving 6,301 neonates were included. Bundle-based quality-improvement packages were associated with lower VAP occurrence (OR = 0.40, 95% CI 0.28-0.57; I² = 37%). MV-adjusted analyses showed lower incidence (IRR = 0.56, 95% CI 0.43-0.73) and 8.33 fewer VAP cases per 1000 MV-days (IRD = -0.0083, 95% CI -0.0127 to -0.0039). Oral care was associated with lower VAP odds (OR = 0.53, 95% CI 0.35-0.81; I² = 3%). Evidence for other interventions was limited and heterogeneous.
conclusionsBundle-based quality-improvement packages were associated with lower neonatal VAP rates, although heterogeneous bundle composition and non-randomized designs limit causal interpretation. Oral care was also associated with lower VAP odds, but confidence in the magnitude of effect is limited by small-study effects, inconsistent subgroup findings, and variable diagnostic criteria. IMPACT: This study provides the most comprehensive synthesis to date focused exclusively on VAP in ventilated neonates, incorporating ventilator-day-adjusted outcomes. By using robust meta-analytic methods across diverse study designs, it clarifies which interventions have consistent evidence and which remain uncertain. Bundle-based quality-improvement packages were associated with meaningful relative and absolute reductions in neonatal VAP. The findings support further evaluation and implementation of bundle-based quality-improvement strategies. Uncertainty regarding the magnitude of benefit from oral care and the need for higher-quality controlled studies.
Identifiers
42918826What OpenQuestion holds
Registered trials
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