Digoxin for preventing or treating neonatal respiratory distress syndrome.

BACKGROUND

This section is under preparation and will be included in the next issue.

OBJECTIVES

To assess the effect of digoxin on clinical outcome in infants at risk of, or with, respiratory distress syndrome (RDS).

SEARCH STRATEGY: Searches were made of the Oxford Database of Perinatal Trials, Medline (MeSH terms: digoxin; limits: age groups, newborn infants; publication type, clinical trial), previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, and journal handsearching in the English language.

SELECTION CRITERIA: Randomized controlled trials of digoxin in either the prevention or treatment of respiratory distress syndrome are included in this overview.

DATA COLLECTION AND ANALYSIS: Data regarding clinical outcomes were excerpted from the trial reports by the reviewer. Data were analyzed according to the standards of the Cochrane Neonatal Review Group.

MAIN

RESULTS

Two randomized controlled trials have studied the effects of digoxin in the prevention and treatment of respiratory distress syndrome. No improvement in respiratory status or mortality was noted. Meta-analysis of the effect of digoxin given to infants at risk of or with RDS on mortality does not suggest any benefit of digoxin treatment (typical relative risk 1.27 95% CI 0.78, 2.07; typical risk difference 0.06, 95% CI -0.06, 0.17).

REVIEWER'S

CONCLUSIONS

Although hemodynamic disturbances play a role in the overall pathogenesis of respiratory distress syndrome, the specific contribution of early congestive heart failure (unrelated to hemodynamically significant patent ductus arteriosus) does not appear to be a significant factor in RDS. Treatment with digoxin has no proven value in infants solely affected with respiratory distress syndrome.