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Cochrane Database of Systematic Reviews

Nebulized racemic epinephrine for extubation of newborn infants

Overview of attention for article published in Cochrane database of systematic reviews, January 2002
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Nebulized racemic epinephrine for extubation of newborn infants
Published in
Cochrane database of systematic reviews, January 2002
DOI 10.1002/14651858.cd000506
Pubmed ID

Mark W Davies, Peter G Davis


Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulized epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. The primary objective was to assess whether nebulized epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. Searches were of: MEDLINE from 1966 to September 2000; CINAHL from 1982 to September 2000; Current Contents from 1994 to September 2000; and the Cochrane Controlled Trials Register (Cochrane Library Issue 3, 2000). These searches were updated to September 2001 for this review update. Previous searches up to March 1999 included the Oxford Database of Perinatal Trials, expert informants and journal hand searching mainly in the English language, previous reviews including cross references, abstracts, and conference and symposia proceedings. All randomised and quasi-randomised control trials in which nebulized epinephrine was compared with placebo immediately post-extubation in newborn infants who have been weaned from IPPV and extubated, with regard to clinically important outcomes (i.e. need for additional respiratory support, increase in oxygen requirement, respiratory distress, stridor or the occurrence of side effects). No studies met our criteria for inclusion in this review. No studies were identified which looked at the effect of inhaled nebulized epinephrine on clinically important outcomes in infants being extubated. There is no evidence either supporting or refuting the use of inhaled nebulized racemic epinephrine in newborn infants. randomised controlled trials are needed comparing inhaled nebulized racemic epinephrine with placebo in neonates post-extubation. This should be looked at both as a routine treatment post-extubation and as specific treatment for post-extubation upper airway obstruction. Study populations should include the group of infants at highest risk for upper airway obstruction from mucosal swelling because of their small glottic and sub-glottic diameters (ie those infants with birthweights less than 1000 grams).

Mendeley readers

The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 70 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 13 19%
Other 8 11%
Student > Postgraduate 6 9%
Student > Master 6 9%
Researcher 4 6%
Other 13 19%
Unknown 20 29%
Readers by discipline Count As %
Medicine and Dentistry 29 41%
Nursing and Health Professions 5 7%
Social Sciences 3 4%
Psychology 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Other 6 9%
Unknown 22 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 January 2019.
All research outputs
of 22,790,780 outputs
Outputs from Cochrane database of systematic reviews
of 12,313 outputs
Outputs of similar age
of 123,711 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 36 outputs
Altmetric has tracked 22,790,780 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 12,313 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.4. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 123,711 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 18th percentile – i.e., 18% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 36 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.